Using Peer Support in Developing Empowering Mental Health Services (UPSIDES): Background, Rationale and Methodology

Abstract

Background: Peers are people with lived experience of mental illness. Peer support is an established intervention in which peers offer support to others with mental illness. A large proportion of people living with severe mental illness receive no care. The care gap is largest in low- and middle-income countries, with detrimental effects on individuals and societies. The global shortage of human resources for mental health is an important driver of the care gap. Peers are an under-used resource in global mental health. Objectives: To describe rationale and methodology of an international multicentre study which will scale-up peer support for people with severe mental illness in high-, middle-, and low-income countries through mixed-methods implementation research. Methods: UPSIDES is an international community of research and practice for peer support, including peer support workers, mental health researchers, and other relevant stakeholders in eight study sites across six countries in Europe, Africa, and Asia. During the first two years of UPSIDES, a series of qualitative studies and systematic reviews will explore stakeholders’ perceptions and the current state of peer support at each site. Findings will be incorporated into a conceptual framework to guide the development of a culturally appropriate peer support intervention to be piloted across all study sites. All intervention and study materials will be translated according to internationally recognised guidelines. Expected Impact: UPSIDES: will leverage the unique expertise of people with lived experience of mental illness to strengthen mental health systems in high-, middle- and low-income countries. UPSIDES will actively involve and empower service users and embed patient-centeredness, recovery orientation, human rights approaches, and community participation into services. The focus on capacity-building of peers may prove particularly valuable in low-resource settings in which shortages of human capital are most severe.

Exposure to HIV risks among young people who use drugs (YPUD) in three cities in Vietnam: time to develop targeted interventions

“…The aim of this study is to identify those among a sample of young drug users (16)(17)(18)(19)(20)(21)(22)(23)(24) in 3 major cities of Vietnam (Hanoi, Haiphong, and HCMC), who are most exposed to HIV, by examining their sexual-and drug use-risk behaviors. The objective is to design a tailored community-based intervention for HIV prevention adapted to their specific needs.…”

Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic multicentre randomised controlled trial (UPSIDES-RCT)

“…CFIR covers five major domains that can influence effective implementation: (i) intervention, (ii-iii) outer and inner setting, (iv) individuals involved, and (v) process. Figure 2 about here ### Building on results of formative research described elsewhere [13,16,17], UPSIDES peer support will be implemented across recruiting sites in line with an implementation manual, taking into account differences across study sites. The development of the manuals as well as their implementation and the overall study design will take into consideration the five CFIR domains by, for example: incorporating adaptations to local contexts; planning for organizational readiness; paying attention to the selection and involvement of relevant stakeholders; and allowing for a staged approach to continuously modify implementation as needed.…”

“…management, counselling, outreach, coaching and advocacy. The intervention has been developed by all UPSIDES partners, through literature review and the adaptation of existing programs [13]: ImROC training (UK [21]), Ex-IN curriculum (Germany [22]), Brain Gain projects (Uganda [23]), QualityRights (WHO [24], India [25]), Healthy Options project (Tanzania [26]), Peer2peer (Europe [27]), and the Yozma Derech-Halev consumer-provider training (Israel [28]).…”

“…UPSIDES takes place over a five-year period (2018 -2022) and is divided into two phases, with different objectives and methods for each phase. The first two years (phase 1) focus on the development and piloting of a culturally appropriate peer support intervention will be developed [13].…”

“…Established state-of-the-art translation guidelines[35] will be followed to translate and locally validate the standardised measures (including administration instructions) used, with special attention paid to the psychometric evaluation of the primary outcome. See Puschner et al[13] for further details on translation.…”