Key Considerations in Integrating a Peer Support Model Within Psychiatric Emergency Services at a Canadian Pediatric Emergency Department: A Qualitative Study

Overview

Journal Community Ment Health J

Specialty Health Services

Date 2024 Sep 30

PMID 39347849

Authors

Julia C Hews-Girard

Emma Cullen

Jessica Sauerwein

Carol Coventry

Gina Dimitropoulos

Affiliations

Soon will be listed here.

Abstract

Difficulties accessing primary care and community-based mental health supports has contributed to youth (aged < 18 years) with mental health concerns presenting to Emergency Departments (EDs). Peer support services in community-based mental health settings are associated with improved outcomes; research exploring this in pediatric EDs is lacking. Determine feasibility and acceptability of integrating peer support services into a pediatric ED. 13 peer support workers (PSWs) and 30 mental health providers and stakeholders participated in interviews or focus groups. Using codebook thematic analysis, recommendations for integration were identified. Key recommendations were: clear conceptualization of youth and family peer support, effective communication pathways between the multidisciplinary team and PSWs, provision of training for ED staff to ensure workplace readiness for peer support, and consistent support for PSWs. Integration of peer support into pediatric EDs offers a feasible and acceptable way to support youth experiencing mental health crises.

References

Braun V, Clarke V . Toward good practice in thematic analysis: Avoiding common problems and be(com)ing a researcher. Int J Transgend Health. 2023; 24(1):1-6. PMC: 9879167. DOI: 10.1080/26895269.2022.2129597. View

Chapman S, Blash L, Mayer K, Spetz J . Emerging Roles for Peer Providers in Mental Health and Substance Use Disorders. Am J Prev Med. 2018; 54(6 Suppl 3):S267-S274. DOI: 10.1016/j.amepre.2018.02.019. View

Chiu M, Gatov E, Fung K, Kurdyak P, Guttmann A . Deconstructing The Rise In Mental Health-Related ED Visits Among Children And Youth In Ontario, Canada. Health Aff (Millwood). 2020; 39(10):1728-1736. DOI: 10.1377/hlthaff.2020.00232. View

Chinman M, George P, Dougherty R, Daniels A, Ghose S, Swift A . Peer support services for individuals with serious mental illnesses: assessing the evidence. Psychiatr Serv. 2014; 65(4):429-41. DOI: 10.1176/appi.ps.201300244. View

Forbes J, Pratt C, Cronise R . Experiences of peer support specialists supervised by nonpeer supervisors. Psychiatr Rehabil J. 2021; 45(1):54-60. DOI: 10.1037/prj0000475. View

Fortuna K, Solomon P, Rivera J . An Update of Peer Support/Peer Provided Services Underlying Processes, Benefits, and Critical Ingredients. Psychiatr Q. 2022; 93(2):571-586. PMC: 8855026. DOI: 10.1007/s11126-022-09971-w. View

Gopalan G, Lee S, Harris R, Acri M, Munson M . Utilization of peers in services for youth with emotional and behavioral challenges: A scoping review. J Adolesc. 2017; 55:88-115. DOI: 10.1016/j.adolescence.2016.12.011. View

Kaur M, Melville Jr R . Emergency Department Peer Support Specialist Program. Psychiatr Serv. 2021; 72(2):230. DOI: 10.1176/appi.ps.72102. View

Kurdyak P, Gandhi S, Holder L, Rashid M, Saunders N, Chiu M . Incidence of Access to Ambulatory Mental Health Care Prior to a Psychiatric Emergency Department Visit Among Adults in Ontario, 2010-2018. JAMA Netw Open. 2021; 4(4):e215902. PMC: 8047734. DOI: 10.1001/jamanetworkopen.2021.5902. View

10.

Lategan C, Newton A, Thull-Freedman J, Stang A, Lang E, Arnold P . An evaluation of satisfaction with emergency department care in children and adolescents with mental health concerns. CJEM. 2023; 25(6):498-507. PMC: 10155139. DOI: 10.1007/s43678-023-00511-4. View

11.

Lo C, Bridge J, Shi J, Ludwig L, Stanley R . Children's Mental Health Emergency Department Visits: 2007-2016. Pediatrics. 2020; 145(6). DOI: 10.1542/peds.2019-1536. View

12.

Mapelli E, Black T, Doan Q . Trends in Pediatric Emergency Department Utilization for Mental Health-Related Visits. J Pediatr. 2015; 167(4):905-10. DOI: 10.1016/j.jpeds.2015.07.004. View

13.

McGuire A, Powell K, Treitler P, Wagner K, Smith K, Cooperman N . Emergency department-based peer support for opioid use disorder: Emergent functions and forms. J Subst Abuse Treat. 2019; 108:82-87. PMC: 7393771. DOI: 10.1016/j.jsat.2019.06.013. View

14.

Murphy R, Huggard L, Fitzgerald A, Hennessy E, Booth A . A systematic scoping review of peer support interventions in integrated primary youth mental health care. J Community Psychol. 2023; 52(1):154-180. DOI: 10.1002/jcop.23090. View

15.

Newton A, Ali S, Johnson D, Haines C, Rosychuk R, Keaschuk R . A 4-year review of pediatric mental health emergencies in Alberta. CJEM. 2009; 11(5):447-54. DOI: 10.1017/s1481803500011647. View

16.

Ojeda V, Munson M, Jones N, Berliant E, Gilmer T . The Availability of Peer Support and Disparities in Outpatient Mental Health Service Use Among Minority Youth with Serious Mental Illness. Adm Policy Ment Health. 2020; 48(2):290-298. PMC: 7870605. DOI: 10.1007/s10488-020-01073-8. View

17.

Otte I, Werning A, Nossek A, Vollmann J, Juckel G, Gather J . Beneficial effects of peer support in psychiatric hospitals. A critical reflection on the results of a qualitative interview and focus group study. J Ment Health. 2019; 29(3):289-295. DOI: 10.1080/09638237.2019.1581349. View

18.

Perou R, Bitsko R, Blumberg S, Pastor P, Ghandour R, Gfroerer J . Mental health surveillance among children--United States, 2005-2011. MMWR Suppl. 2013; 62(2):1-35. View

19.

Satinsky E, Kleinman M, Tralka H, Jack H, Myers B, Magidson J . Peer-delivered services for substance use in low- and middle-income countries: A systematic review. Int J Drug Policy. 2021; 95:103252. DOI: 10.1016/j.drugpo.2021.103252. View

20.

Wiens K, Bhattarai A, Pedram P, Dores A, Williams J, Bulloch A . A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018. Epidemiol Psychiatr Sci. 2020; 29:e115. PMC: 7214527. DOI: 10.1017/S2045796020000281. View