Table 1 Brain Gain II Peer Support Workers

Qualifications

PSWs must be adults (age 18+) with lived experience of mental or neurological disorders who are numerate, literate in at least one language and able to communicate in basic English. There is no minimum educational or professional qualification required to become a PSW.

Training

Thirty PSWs from communities in Kampala and nearby districts identified by the user-led organisation HeartSounds Uganda were trained in 2012, prior to the start of Brain Gain II. The five-day training was delivered in Kampala by three mental health professionals from the UK with experience managing peer support programmes. Training covered principles of peer support work, recovery and wellness, communications skills, techniques for managing aggression and using Tree of Life as a tool to positively reframe personal narratives of illness and recovery [31]. In March 2015 the trained PSWs participated in an additional Training of Trainers as part of Brain Gain II, to help build the capacity of new cohorts of PSWs [37]. The Training of Trainers has since been manualised and is available upon request.

Supervision

Group supervision is provided via Monthly Advisory Support Group meetings at Butabika. These meetings create opportunities for PSWs to discuss their work with one another and with Butabika staff, creating a forum for shared learning and problem-solving. If a particularly challenging medical or social issue is encountered, a PSW may request that a trusted staff member—usually a social worker or a nurse from Butabika’s Community Recovery Team—participate in the next visit. Monthly Advisory Support Group meetings are also opportunities to monitor the well-being of PSWs and provide additional support to those who are struggling. A PSW’s caseload may be redistributed to other PSWs from nearby communities, if necessary. A PSW recovering from a relapse is assessed by a psychiatrist at Butabika before resuming peer support visits.

Quality Assurance

At each visit, the PSW completes a structured follow-up form, which documents essential information such as the user’s up-to-date contact information and details about what took place. Forms are reviewed regularly by a M&E Officer to identify any inconsistencies which might suggest that a visit has not taken place, in which case an additional visit may be conducted by a Butabika staff member, to investigate.

Compensation

Although PSWs are not salaried hospital staff, they receive a lunch and travel stipend of 20,000 UGX (approximately $5 USD equivalent) for each day of activity.