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Table 1 Detailed characteristics of studies

From: The effectiveness of one-to-one peer support in mental health services: a systematic review and meta-analysis

Study Country Method Population Sample size: intervention /control Intervention Control Outcomes Assessments Longest Follow Up Type of PS Support for PS
Solomon, 1995 [23] USA Randomised controlled trial Adults currently on community mental health centre caseload who meet all three criteria for intensive case management and were identified to be at risk for hospitalisation with a diagnosis of major mental illness and a significant treatment history 48/48 Consumer case management Case management as usual from community mental health services 1) Overall psychiatric symptomsb
2) Social network support b
3) Quality of life b
4) Hospitalisationb
5) Working Alliance
1) Brief Psychiatric Rating Scale (BPRS) [24]b
2) Pattison’s Social Network [25]b
3) Lehmans’s Quality of Life Interview [26]b
4) Days in hospitalb
5) Working Alliance Inventory - staff and client [27]b
24 months S H
Klein, 1998 [28] USA Randomised controlled trial - pilot Adult patients receiving intensive care management with dual diagnosis who had been in community care at the mental health centre for 1 year 10/51 Peer-supported community enablement plus CAU CAU - Intensive Case Management 1) Hospitalisation
2) Social functioning
3) Quality of Life
4) Social network support
5) Wellbeing
1) Days in hospital
2) Global Assessment of Functioning (GAF) Scale [29]
3) Lehman’s Quality of Life (QOL) [26]
4) Lehman’s Quality of Life – Friends subscale [26]
5) Lehman’s Quality of Life – Health subscale [26]
6 months A H
Clarke, 2000 [30] USA Randomised controlled trial – three arms Adult patients with a severe mental disorder, a schizophrenic, major affective, or paranoid disorder, or another severe mental disorder, and a documented history of persistent psychotic symptoms other than those caused by substance abuse. 57/57/49 Consumer-staffed assertive community treatment 1) Non-consumer assertive community treatmenta
2) CAU – usual community mental health services
1) Hospitalisationb 1) Hospitalisedb
Community tenure (days)
6 months S L
Hunkeler, 2000 [31] USA Randomized controlled trial – three arms Adults primary care patients with a diagnosis of major depressive disorder or dysthymia and given a prescription of for a SSRI antidepressant (fluoxetine hydrochloride or paroxetine) 123/117/62 Peer support via telephone contact or face-to-face plus nurse telehealth care plus nurse telehelthcare plus CAU 1) Nurse teleheath care plus CAU 2) CAU – usual physician care 1) Depression and anxiety
2) Social functioning
3) Satisfaction with services
1) Hamilton Depression Rating Scale- self report version [32]
- Beck depression Inventory [33]
2) SF − 12 Mental and Physical Composite Scales [34]
3) Patient satisfaction with treatment scale – no information provided
6 months A L
Craig, 2004 [35] England Randomised controlled trial - pilot Adult service users currently registered with assertive outreach team and have SMI, with a record of poor engagement, multiple hospitalisations and a high prevalence of problematical behaviours and substance abuse. 24/21 Consumer Health Care Assistant plus CAU CAU - case management from Assertive Outreach Team 1) Social functioning b
2) Social network support b
3) Hospitalisationb
4) Satisfaction with services
5) Service engagement
1) Life Skills Profile [36]b
2) Significant others scale (SOS) [37]
3) Days in hospitalb
Hospitalisedb
4) Verona Service Satisfaction Scale (VSSS) [38]b
5) Number of missed (DNA) appointments with services.
12 months A H
Sells, 2006 [39] USA Randomised controlled trial Adult patients currently using local mental health authorities with a primary diagnosis of SMI (schizophrenia spectrum disorder, major mood disorder, or both) and treatment disengagement 58/59 Peer-based case management from peer mental health service provider Case management as usual from assertive community treatment teams 1) Working alliance - clientb
2) Engagement with services
1) Barrett-Lennard Relationship Inventory (BLRI) modified version [40]b
2) Level of Care Utilization System [41]
12 months A L
Rivera, 2007 [42] USA Randomised controlled trial – three arms Adults recruited from inpatient units at a city hospital whom have a diagnosis of a psychotic or mood disorder on axis I, and have had two or more psychiatric hospitalizations in previous two years 70/66/67 Consumer-assisted intensive case management 1) Intensive case managementa 2) Standard case management (i.e. office-based without intensive components) 1) Overall psychiatric symptomsb
2) Quality of Lifeb
3) Social network supportb
4) Wellbeingb
5) Hospitalisationb
1) Brief Symptom Inventory [43]b
2) Lehman Quality of Life Inventory [26]b
3) Modification of Pattison Network Inventory [25]b
4) Lehman’s Quality of Life - health subscale [26]b
5) Days in hospital (per month)b
12 months A L
Simon, 2011 [44] USA Randomised controlled trial Participants, aged 19 or over, who were currently in treatment for bipolar disorder 64/54 Online peer recovery coaching plus online recovery planning Online recovery planning 1) Engagement with services 1) Use of online program components - engagement with recovery plans, use of social networking features, use of self-monitoring tools. 3 weeks A H
Sledge, 2011 [45] USA Randomised controlled trial - pilot Adult inpatients who have experienced three or more psychiatric hospitalizations (or two admissions plus more than three psychiatric ED visits) during the 18-month period prior to recruitment and have a documented diagnosis of schizophrenia, schizoaffective disorder, psychotic disorder not otherwise specified, bipolar disorder or major depressive disorder with or without psychotic features 48/45 Community-based peer recovery mentor plus CAU CAU - community mental health care 1) Hospitalisationb
2) Overall psychiatric symptoms
3) Social Functioning
4) Hope
5) Satisfaction with services
6) Social network support
7) Wellbeing
1) No. of readmissions
- Days in hospitalb Hospitalisedb
Community tenure
2) Brief Psychiatric Rating Scale (BPRS) [24]
3) The Social Functioning Scale [46]
4) The Dispositional Hope Scale [47]
5) Mental Health Statistics Improvement Programme (MHSIP) [48]
6) Sense of Community Index [49]
7) 36 item Short Form Health Survey (SF-36) [34]
9 months A H
Proudfoot, 2012 [50] Australia Randomised controlled trial – three arms Adults diagnosed with bipolar disorder by a health professional within the past 12 months and currently being treated 134/139/134 Online peer coaching plus online psycho-education programme 1) Online psycho-education programme
2) attention control
1) Depression and anxiety
2) Social functioning
3) Empowerment
1) Goldberg Anxiety and Depression Scale (GADS) [51]
2) Work and Social Adjustment Scale [52]
3) Multi-dimensional Health Locus of Control [53]
6 months A L
Chinman, 2013 [54] USA Cluster randomised controlled trial Current adult VA intensive case management patients who have had 30 psychiatric inpatient days or 3 psychiatric admissions in the past year with an Axis 1 psychiatric disorder. 252/216 Floating, additional peer-supported case management plus CAU CAU - case management from community-based Intensive Case Management services 1) Quality of Lifeb
2) Recoveryb
3) Empowermentb
4) Overall psychiatric symptomsb
1) Lehman’s Quality of Life Interview [26]b
2) The Mental Health Recovery Measure (MHRM) [55]b
Illness Management and Recovery Scale (IMR Scale) [56]
3) Patient Activation Measure [57]b
4)BASIS-R [58] b
QoL - 6 months
Other - 12 months
A H
Simpson, 2014 [59] England Randomised controlled trial - pilot Inpatients, aged 18–65, approaching discharge/extended leave from acute mental health inpatient unit 23/23 Peer support plus CAU CAU - community mental health services 1) Hope
2) Quality of Life
3) Hospitalisationb
1) Beck Hopelessness Scale (BHS - 20 item) [60]
2) EuroQol (EQ-5D) [61]
3) Hospitalisedb
3 months A H
Wrobleski, 2015 [62] Canada Randomized controlled trial - pilot Adult patients receiving care from a community mental health service with a persistent mental illness, that is significantly affecting daily functioning or a person with both a mental health diagnosis and substance use issue 12/9 Peer-supported self-management plus occupational therapy Self-management support from a (non-peer) mental health worker plus occupational therapy 1) Quality of Life 1) Lehman’s Quality of Life Interview [26] 6 months S H
Rogers, 2016 [63] USA Randomised controlled trial Clients, over the age of 18, who were court ordered for treatment because of a psychiatric crisis civilly committed for a mental health crisis, adjudicated by the state court to meet the definition of “a person with a serious mental illness,” 63/50 Individual peer-supported social inclusion and recovery support plus CAU CAU - Peer-provided services (excluding individual peer support; e.g. social activities, educational courses, group peer support) 1) Social network support
2) Overall psychiatric symptoms
3) Recovery
4) Quality of Life
1) Interpersonal Support Evaluation List [64]
2) BASIS-R [58]
3) Recovery Assessment Scale [65]
4) Brief Quality of Life (BQOL; Lehman, 1988) [26]
6 months A H
Salzer, 2016 [66] USA Randomized controlled trial Patients, aged 18 and above, using community outpatient mental health programmes with a diagnosis on the schizophrenia spectrum, bipolar disorder, or major depression 50/50 Peer-delivered support for independent living plus CAU CAU - usual outpatient mental health care 1) Quality of lifeb
2) Recovery b
3) Empowermentb
4) Working Alliance
1) Lehman’s Quality of Life Interview [26]b
2) Recovery Assessment Scale [65]b
3) The Empowerment Scale [67]b
4) Working Alliance Inventory [27]
12 months A H
Seeley, 2016 [68] USA Randomized controlled trial - pilot Patients, aged 55 and above, referred to an intergovernmental agency and meeting criteria for mild to moderate depression and/or anxiety 31/31 Peer-supported cognitive behavioural intervention for mild-moderate depression and/ or anxiety Waitlist control 1) Depression b
2) Anxiety
3) Working Alliance
1) PHQ-9 [69]b
2) GAD-7 [70]
3) Working Alliance Inventory [27]
2.5 months A L
Mahlke, 2017 [71] Germany Randomised controlled trial Patients, aged 18–80, using in- and out-patient services with primary diagnosis of schizophrenia and related disorders, affective disorders, or personality disorder and a duration of illness of more than 2 years. 114/112 Community-based peer support for individual recovery plus CAU CAU - in-patient and out-patient mental health as usual 1) Overall psychiatric symptomsb
2) Quality of Lifeb
3) Social functioningb
4) Empowermentb
5) Hospitalisationb
1) Clinical Global Impression – Severity scale [72]
2) Modular System for Quality of Life and EuroQol
Questionnaire EQ. 5D [61]b
3) Global Assessment of Functioning (GAF) Scale [29]b
4) General Self-Efficacy Scale [73]b
5) Days in hospitalb
Hospitalisedb
12 months A H
Yamaguchi, 2017 [74] Japan Randomized controlled trial Patients, age 20 years or older, using outpatient psychiatric clinic or psychiatric hospital in Tokyo, who received services from case managers in either a psychiatric day care or visiting nurse program. 26/27 Peer supported shared decision-making plus CAU CAU - medical consultation 1) Overall psychiatric symptomsb
2) Social Functioningb
3) Empowermentb
4) Working Allianceb
1) The Brief Psychiatric Rating Scale (BPRS) [24]b
2) Global Assessment of Functioning (GAF) Scale [29]b
3) Patient Activation Measure [57]b
4) Scale To Assess Therapeutic Relationships in Community Mental Health Care (STAR) – Clinician
& Patient versions [75] b
12 months A L
Johnson, 2018 [76] England Randomised controlled trial Adult patients currently on the caseload of crisis resolution teams for at least a week because of a psychiatric crisis 221/220 Peer-supported self-management plus CAU CAU – community mental health services plus self-management workbook 1) Overall psychiatric symptomsb
2) Social network support b
3) Recovery b
4) Satisfaction with servicesb
5) Hospitalisation
1) Brief Psychiatric Rating Scale [24]b
2) Lubben Social Network Scale [77]b
3.a) Illness Management & Recovery Scale b (patient version) [56]
3.b) Questionnaire on the Process of Recovery (QPR) [78]
4) Client Satisfaction Questionnaire [79]b 5) Community tenure (days)
18 months A H
  1. Key: PS Peer Support, A Adjunctive, S Substitute, L Low level of organisational support for peer support, H High level of support for peer support; a Comparator included in meta analysis; b Outcome/ assessment included in meta analysis