Peer support work for people experiencing mental distress attending the emergency department: Exploring the potential.

OBJECTIVE: This study explored the benefits and limitations of employing peer support workers, who utilise their own lived experience of mental distress and recovery, to support people experiencing mental distress who are attending the ED. METHODS: This co-produced qualitative study utilised four phases: (i) assemble a collaborative multi-disciplinary research team and Expert Panel, of which at least half identified as having lived experience; (ii) a site visit to an ED; (iii) focus groups with consumers, support persons and ED staff; and (iv) a learning workshop for peer workers. RESULTS: Focus groups were run for consumers (n = 7), support persons (n = 5) and ED staff (n = 7). Eleven consumer peer workers participated in the learning workshop. Four themes were identified and triangulated: the individual in distress, peer support work, a 'Peers in EDs' service and the ED context. Overall, findings suggest that peer support workers contribute important skills including listening, de-escalation, relationship-building and empathy. CONCLUSIONS: This study identified that peer support workers would bring important skills to an ED (e.g. empathetic support, de-escalation). However, significant workforce and organisational support would be required.

Psychosocial Factors Affecting Smoking Cessation Among People Living With Schizophrenia: A Lived Experience Lens.

Introduction: People living with schizophrenia smoke at much higher rates than the general population, and find it more difficult to quit. To date, lived experience has received little attention from researchers. Personal recovery perspectives may generate further insights into established psychosocial barriers and enablers of smoking cessation. Methods and Results: A lived experience account is provided by one of our authors that places the current evidence in context, and highlights the role of marginalization and stigma in reinforcing smoking. Key concepts from the personal recovery paradigm, such as connectedness, hope, and empowerment are discussed. The relevance of these factors and the value of shared lived experience in challenging stigma, marginalization, and low expectations demonstrates the contribution that peer support can offer to support smoking cessation. Conclusions: Recovery-oriented approaches when integrated with existing evidence-based treatments designed to meet the needs of people living with schizophrenia have potential to improve outcomes by helping to take a more holistic approach to break down barriers and facilitate increased uptake of treatment and support. Further research to evaluate the effectiveness of integrated approaches is warranted.

The growth of peer support: an international charter.

Objective: While mental health peer support originated in its contemporary form in English-speaking countries, it is now spreading rapidly across the globe. This rapid growth presents two major challenges. The first pertains to "role integrity" and the second to the possible culture-bound nature of peer support; a concern which has attended the emergence of peer support in countries that have significantly different worldviews.Method: Recognizing the growth of peer support and the resulting challenges, this report results from the convening of an international consortium of peer leaders from six continents (all but Antarctica). Following an environmental scan of the state of peer support globally, this group moved to develop consensus on a common, core set of guiding principles and values to ensure a robust future for the development of effective, culturally responsive forms of peer support.Findings: Key principles, values and practices considered essential to peer support are presented.Conclusions and implications for practice: Assuming that sufficient political and community support are generated, there can be considerable enthusiasm for the expansion of peer support around the globe. Peer leaders are encouraged, however, to develop and deliver peer support both with integrity to its founding values in a civil rights and social justice framework and with responsiveness to local cultural worldviews.

The global need for lived experience leadership.

TOPIC: Common challenges and experiences of the lived experience/peer workforce globally are considered, with an emphasis on ensuring that future developments both protect and promote the unique lived experience perspective. PURPOSE: In the Western world, rapid growth in lived experience roles has led to an urgent need for training and workforce development. However, research indicates the roles risk being coopted without clear lived experience leadership, which is often not occurring. In developing countries and in many Western contexts, the lived experience role has not yet been accepted within the mental health workforce. The need for lived experience leadership to guide these issues is highlighted. SOURCES: Peer-reviewed research, relevant gray literature, and professional experience in countries where little published material currently exists. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A window of opportunity currently exists to maximize lived experience leadership, and that window may be closing fast if broad-based actions are not initiated now. (PsycINFO Database Record

Community treatment orders: towards a new research agenda.

OBJECTIVES: The aim of this study was to report on a half-day multi-stakeholder symposium on community treatment orders (CTOs) hosted by the Melbourne Social Equity Institute (MSEI), which identified research gaps and opportunities, and produced an agreed agenda for future CTO research. METHODS: The MSEI convened a symposium for 22 experts in CTO research to discuss research priorities in this field in Australasia. An independent moderator elicited views and recommendations and produced a report detailing possible research projects. RESULTS: Research on CTOs is contentious and there is a need to gather and examine information regarding both their use and utility. Due to the complexities involved, it was agreed that research should be undertaken in partnership with persons with had lived experience of mental health problems, clinicians, policymakers and other interdisciplinary stakeholders. Five key areas for future investigation were identified. CONCLUSIONS: The issues and recommendations arising from the symposium should shape the scope, nature and conduct of future research directions in the field.

Embedding a Recovery Orientation into Neuroscience Research: Involving People with a Lived Experience in Research Activity.

This paper highlights the importance and value of involving people with a lived experience of mental ill health and recovery in neuroscience research activity. In this era of recovery oriented service delivery, involving people with the lived experience of mental illness in neuroscience research extends beyond their participation as "subjects". The recovery paradigm reconceptualises people with the lived experience of mental ill health as experts by experience. To support this contribution, local policies and procedures, recovery-oriented training for neuroscience researchers, and dialogue about the practical applications of neuroscience research, are required.

Recovery, medication and shared responsibility in mental health care.

OBJECTIVE: The recovery paradigm is significantly influencing contemporary mental health services. This paper explores using a recovery orientation when introducing, prescribing, administering and monitoring medication as part of treatment in psychiatry. CONCLUSIONS: Recovery is not 'anti' medication; however, a recovery-oriented position does require the adoption of an enabling and empowering approach to the use of medication. The cornerstone of this is shared decision-making that respects the person's own lived experience and choice as well as the practitioner's professional expertise. This paper suggests that by taking this path, relationships between psychiatrists, other clinicians and consumers will be enhanced.

Integrating recovery-oriented practice into psychiatric registrar training.

OBJECTIVE: This paper describes a new initiative in training for psychiatry trainees in the 'recovery' paradigm. CONCLUSIONS: Supporting patients in their personal recovery and promoting wellbeing has become a key principle in the delivery of specialist mental health services. This requires psychiatrists to develop (or perhaps return to) a worldview that promotes a hopeful stance and acknowledges the importance of relationships when working with people experiencing mental ill health. In 2011, the authors developed and trialed training about personal recovery and wellbeing within psychiatry. A crucial factor was that the training was delivered by a person who has expertise both as a result of their own recovery journey and their experience in peer support work. The feedback from participants has supported further national and international developments and there are plans to extend this component of the program.