Older Adult Peer Support Specialists’ Age-Related Contributions to an Integrated Medical and Psychiatric Self-Management Intervention: Qualitative Study of Text Message Exchanges

Abstract

Background Middle-aged and older adults with mental health conditions have a high likelihood of experiencing comorbid physical health conditions, premature nursing home admissions, and early death compared with the general population of adults aged 50 years or above. An emerging workforce of peer support specialists aged 50 years or above or “older adult peer support specialists” is increasingly using technology to deliver peer support services to address both the mental health and physical health needs of middle-aged and older adults with a diagnosis of a serious mental illness. Objective This exploratory qualitative study examined older adult peer support specialists’ text message exchanges with middle-aged and older adults with a diagnosis of a serious mental illness and their nonmanualized age-related contributions to a standardized integrated medical and psychiatric self-management intervention. Methods Older adult peer support specialists exchanged text messages with middle-aged and older adults with a diagnosis of a serious mental illness as part of a 12-week standardized integrated medical and psychiatric self-management smartphone intervention. Text message exchanges between older adult peer support specialists (n=3) and people with serious mental illnesses (n=8) were examined (mean age 68.8 years, SD 4.9 years). A total of 356 text messages were sent between older adult peer support specialists and service users with a diagnosis of a serious mental illness. Older adult peer support specialists sent text messages to older participants’ smartphones between 8 AM and 10 PM on weekdays and weekends. Results Five themes emerged from text message exchanges related to older adult peer support specialists’ age-related contributions to integrated self-management, including (1) using technology to simultaneously manage mental health and physical health issues; (2) realizing new coping skills in late life; (3) sharing roles as parents and grandparents; (4) wisdom; and (5) sharing lived experience of difficulties with normal age-related changes (emerging). Conclusions Older adult peer support specialists’ lived experience of aging successfully with a mental health challenge may offer an age-related form of peer support that may have implications for promoting successful aging in older adults with a serious mental illness.

An Update of Peer Support/Peer Provided Services Underlying Processes, Benefits, and Critical Ingredients

“…New endorsements or peer support specializations that build on state peer support training and certifications include training on older adult peer support [43], digital peer support [44], and forensic peer support [45]. Professional development may include training in specific interventions, some empirically-supported, such as Whole Health Action Management to improve health for high incidence chronic medical conditions [46], Wellness Recovery Action Planning [11], trauma-informed peer support for people living with HIV [47], and peer support for mothers with mental health challenges [48].…”

The Intersection of Business Innovation and Scientific Exploration to Address Early Mortality in People With Serious Mental Illness

“…5 To date, D-COAPs use text messaging that is compliant with the Health Insurance Portability and Accountability Act to support self-management of medical and psychiatric conditions through medication management, role management, and emotional management support. 5,6 D-COAPS also support individuals with social health challenges related to wellness and independent living (eg, loneliness, access to aging-in-place services, and fall prevention) by offering wisdom gained from aging with an SMI and guidanceforwellness-orientedself-regulation(eg,deepbreathing,mindfulness,stressreduction,meditation,andyoga). 5,6 This support has resulted in promising evidence of increasedself-managementskills,improvedqualityoflife,and improved mental health symptoms.…”

“…5,6 D-COAPS also support individuals with social health challenges related to wellness and independent living (eg, loneliness, access to aging-in-place services, and fall prevention) by offering wisdom gained from aging with an SMI and guidanceforwellness-orientedself-regulation(eg,deepbreathing,mindfulness,stressreduction,meditation,andyoga). 5,6 This support has resulted in promising evidence of increasedself-managementskills,improvedqualityoflife,and improved mental health symptoms. 6 D-COAPS services have expanded beyond traditional self-management programs for people with SMI who are 50 years or older, such as the Helping Older Adults Experience Success and Integrated Illness Management and Recovery programs by focusing on self-management and social health.…”

“…To begin, older adults with SMI have developed an emerging, untapped national workforce of digital certified older adult peer support specialists (D-COAPS), who are individuals with a lived experience of aging with an SMI . In the US, D-COAPS are a Medicaid-reimbursable workforce trained and accredited to use synchronous and asynchronous text messaging and peer-supported smartphone apps to deliver evidence-based programs .…”

“…To begin, older adults with SMI have developed an emerging, untapped national workforce of digital certified older adult peer support specialists (D-COAPS), who are individuals with a lived experience of aging with an SMI . In the US, D-COAPS are a Medicaid-reimbursable workforce trained and accredited to use synchronous and asynchronous text messaging and peer-supported smartphone apps to deliver evidence-based programs . To date, D-COAPs use text messaging that is compliant with the Health Insurance Portability and Accountability Act to support self-management of medical and psychiatric conditions through medication management, role management, and emotional management support .…”