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Community mental health journal
05, 2024;60 (4): 784-795.

"I Think Peer Support Helps to Demystify People Who Have Mental Health Issues and Helps to Remove That Stigma": Exploring the Defining Characteristics and Related Challenges of Youth Peer Support Through Participatory Research.

Tanya Halsall, Mardi Daley, Lisa D Hawke, Jo Henderson, Anne Wilson, Kimberly Matheson
Author Information
  1. Tanya Halsall: University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada. tanya.halsall@theroyal.ca. ORCID
  2. Mardi Daley: LOFT Community Services, 721 Bloor St. W Suite 301, Toronto, ON, M6G 1L5, Canada.
  3. Lisa D Hawke: Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada.
  4. Jo Henderson: Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada.
  5. Anne Wilson: LOFT Community Services, 721 Bloor St. W Suite 301, Toronto, ON, M6G 1L5, Canada.
  6. Kimberly Matheson: University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada.
PMID: 38430287 DOI: 10.1007/s10597-024-01235-0

Abstract

Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming.

Keywords

Evaluation Mental health PAR—participatory action research Peer support Qualitative research Substance use health Youth

References

  1. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. [DOI: 10.1191/1478088706qp063oa]
  2. Canadian Agency for Drugs and Technologies in Health (CADTH). (2022). CADTH health technology review: Peer support programs for youth mental health. Canadian Journal of Health Technologies, 2(11), 1–134.
  3. Checkoway, B., & Richards-Schuster, K. (2003). Youth participation in community evaluation research. American Journal of Evaluation, 24(1), 21–33. [DOI: 10.1177/109821400302400103]
  4. Conley, C. S., Hundert, C. G., Charles, J. L., Huguenel, B. M., Al-khouja, M., Qin, S., & Corrigan, P. W. (2020). Honest, open, proud–college: Effectiveness of a peer-led small-group intervention for reducing the stigma of mental illness. Stigma and Health, 5(2), 168. [DOI: 10.1037/sah0000185]
  5. Daley, M., & Egag, E. (2019). Creating, managing and supporting spaces for young adult experts and peers. Retrieved July 18, 2023 from https://www.homelesshub.ca/sites/default/files/attachments/Spaces%20for%20YAP%20Final%20Report%202019.pdf
  6. de Beer, C. R. M., Nooteboom, L. A., van Domburgh, L., de Vreugd, M., Schoones, J. W., & Vermeiren, R. R. J. M. (2022). A systematic review exploring youth peer support for young people with mental health problems. European Child & Adolescent Psychiatry, 2022, 1–14.
  7. de Beer, C. R., van Domburgh, L., Vermeiren, R. R., de Vreugd, M., & Nooteboom, L. A. (2023). Improving collaboration between youth peer support workers and non-peer colleagues in child and adolescent mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 2023, 1–10.
  8. Delman, J., & Klodnick, V. V. (2017). Factors supporting the employment of young adult peer providers: Perspectives of peers and supervisors. Community Mental Health Journal, 53, 811–822. [DOI: 10.1007/s10597-016-0059-6]
  9. DeLuca, J. S. (2020). Conceptualizing adolescent mental illness stigma: Youth stigma development and stigma reduction programs. Adolescent Research Review, 5, 153–171. [DOI: 10.1007/s40894-018-0106-3]
  10. Edwards, P. K., O’Mahoney, J., & Vincent, S. (2014). Studying organizations using critical realism: A practical guide. Oxford University Press. [DOI: 10.1093/acprof]
  11. Gopalan, G., Lee, S. J., Harris, R., Acri, M. C., & Munson, M. R. (2017). Utilization of peers in services for youth with emotional and behavioral challenges: A scoping review. Journal of Adolescence, 55, 88–115. [DOI: 10.1016/j.adolescence.2016.12.011]
  12. Halsall, T., & Forneris, T. (2016). Behind the scenes of youth-led community events: A participatory evaluation approach using Photovoice in a Canadian First Nation community. Youth Engagement in Health Promotion, 1(2), 1–40.
  13. Halsall, T., Daley, M., Hawke, L. D., & Henderson, J. (2021a). Exploring peer support services for youth experiencing multiple health and social challenges in Canada: A hybrid realist-participatory evaluation model. International Journal of Qualitative Methods, 20, 1–13. [DOI: 10.1177/1609406921995680]
  14. Halsall, T., McCann, E., & Armstrong, J. (2021b). Engaging young people within a collaborative knowledge mobilization network: Development and evaluation. Health Expectations, 2021, 1–11.
  15. Halsall, T., Daley, M., Hawke, L. D., Henderson, J., & Matheson, K. (2022). “You can kind of just feel the power behind what someone’s saying”: A participatory-realist evaluation of peer support for young people coping with complex mental health and substance use challenges. BMC Health Services Research, 22, 1358. [DOI: 10.1186/s12913-022-08743-3]
  16. Halsall, T., Daley, M., Hawke, L. D., Henderson, J., & Matheson, K. (2023). “You can create a little bit more closure in your own story when someone really connects with it”: Exploring how involvement in youth peer support work can promote peer development. International Journal of Mental Health Systems, 17(1), 34. [DOI: 10.1186/s13033-023-00608-4]
  17. Hopkins, L., Pedwell, G., Wilson, K., & Howell-Jay, P. (2021). Implementing youth peer support in an early psychosis program. The Journal of Mental Health Training, Education and Practice, 16(2), 85–98. [DOI: 10.1108/JMHTEP-03-2020-0014]
  18. Hundert, C. G., Hareli, M., & Conley, C. S. (2022). Honest, open, proud—college: Follow-up effects of a peer-led group for reducing the stigma of mental illness. Stigma and Health, 7(1), 122. [DOI: 10.1037/sah0000326]
  19. Kelly, L. (2018). W2A embrace Life process evaluation: Learning from the experiences of youth hosts and planning team members. The Ontario Centre of Excellence for Child and Youth Mental Health and Wisdom2Action. Retrieved May 26, 2023, from https://www.wisdom2action.org/wp-content/uploads/2020/01/W2A-Embrace-Life-Process-Evaluation.pdf
  20. Kidd, S. A., Vitopoulos, N., Frederick, T., Daley, M., Peters, K., Cohen, S., Gutierrez, R., Leon, S., & McKenzie, K. (2019a). Peer support in the homeless youth context: Requirements, design, and outcomes. Child and Adolescent Social Work Journal, 36, 641–654. [DOI: 10.1007/s10560-019-00610-1]
  21. Kidd, S. A., Vitopoulos, N., Frederick, T., Leon, S., Karabanow, J., & McKenzie, K. (2019b). More than four walls and a roof needed: A complex tertiary prevention approach for recently homeless youth. American Journal of Orthopsychiatry, 89(2), 248. [DOI: 10.1037/ort0000335]
  22. Kirsch, D. J., Pinder-Amaker, S. L., Morse, C., Ellison, M. L., Doerfler, L. A., & Riba, M. B. (2014). Population-based initiatives in college mental health: Students helping students to overcome obstacles. Current Psychiatry Reports, 16, 1–8. [DOI: 10.1007/s11920-014-0525-1]
  23. Mulfinger, N., Müller, S., Böge, I., Sakar, V., Corrigan, P. W., Evans-Lacko, S., Nehf, L., Djamali, J., Samarelli, A., Kempter, M., Ruckes, C., Libal, G., Oexle, N., Noterdaeme, M., & Rüsch, N. (2018). Honest, open, proud for adolescents with mental illness: Pilot randomized controlled trial. Journal of Child Psychology and Psychiatry, 59(6), 684–691. [DOI: 10.1111/jcpp.12853]
  24. Ontario Centre of Excellence for Child and Youth Mental Health. (2018). Evidence in-sight: Youth peer support training literature review and environmental scan. Ontario Centre of Excellence for Child and Youth Mental Health.
  25. Pawson, R. (2013). The science of evaluation: A realist manifesto. Sage Publications Ltd. [DOI: 10.4135/9781473913820]
  26. Sabo Flores, K. (2008). Youth participatory evaluation: Strategies for engaging young people. Jossey-Bass.
  27. Simmons, M. B., Coates, D., Batchelor, S., Dimopoulos-Bick, T., & Howe, D. (2018). The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service. Early Intervention in Psychiatry, 12(5), 964–971. [DOI: 10.1111/eip.12527]
  28. Simmons, M. B., Grace, D., Fava, N. J., Coates, D., Dimopoulos-Bick, T., Batchelor, S., Howe, D., & Montague, A. E. (2020). The experiences of youth mental health peer workers over time: A qualitative study with longitudinal analysis. Community Mental Health Journal, 56, 906–914. [DOI: 10.1007/s10597-020-00554-2]
  29. Stewart, M., Reutter, L., Letourneau, N., & Makwarimba, E. (2009). A support intervention to promote health and coping among homeless youths. Canadian Journal of Nursing Research Archive, 2009, 54–78.
  30. Tam, T. (2019). Addressing stigma: Towards a more inclusive health system. Public Health Agency of Canada. Retrieved August 14, 2023, from https://www.canada.ca/content/dam/phac-aspc/documents/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/addressing-stigma-what-we-heard/stigma-eng.pdf
  31. Tan, J., Bernard, B., Chung, J., Debbouz, M. A., Fehr, V., Frampton, A., Sara, J., McLean, H. M., Poukhovski-Sheremetyev, F., Saunders, E., Thomas, L., Viens-Maranda, J., & Mireault, C. (2019). Invited commentary: ACCESS open minds national youth council. Early Intervention in Psychiatry, 13, 65–67. [DOI: 10.1111/eip.12820]
  32. Tisdale, C., Snowdon, N., Allan, J., Hides, L., Williams, P., & de Andrade, D. (2021). Youth mental health peer support work: A qualitative study exploring the impacts and challenges of operating in a peer support role. Adolescents, 1(4), 400–411. [DOI: 10.3390/adolescents1040030]
  33. Vitopoulos, N. A., Frederick, T. J., Leon, S., Daley, M., McDonald, C., Morales, S., Leysa, C. K., Sue, C., Karen, E., Carol, H., Rose, G., Karen, M., Kamika, P., Julia, V., Kwame, M., & Kidd, S. A. (2018). Development of a complex tertiary prevention intervention for the transition out of youth homelessness. Children and Youth Services Review, 94, 579–588. [DOI: 10.1016/j.childyouth.2018.08.038]
  34. Walker, J. S., Baird, C., & Welch, M. B. (2018). Peer support for youth and young adults who experience serious mental health conditions: State of the science. Research and Training Center for Pathways to Positive Futures, Portland State University.
  35. Willis, M. E. (2023). Critical realism and qualitative research in psychology. Qualitative Research in Psychology, 20(2), 265–288. [DOI: 10.1080/14780887.2022.2157782]
  36. Wong, G., Greenhalgh, T., Westhorp, G., Buckingham, J., & Pawson, R. (2013). RAMESES publication standards: realist syntheses. BMC Medicine, 11, 1–14.
  37. Zeldin, S., Bestul, L., & Powers, J. (2012). Youth-adult partnerships in evaluation (Y-AP/E): A resource guide for translating research into practice. ACT for Youth Center of Excellence, Cornell University.

Grants

  1. 892-2018-3059/Social Sciences and Humanities Research Council of Canada

MeSH Term

Humans
Adolescent
Mental Health
Community-Based Participatory Research
Counseling
Focus Groups
Peer Group
Journal Article Research Support, Non-U.S. Gov't

Word Cloud

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