October 12th 2017

Co-production in the qualitative approach to peer support values

About the McPin Foundation

What we do:• Guidance and expert support on public and patient

involvement in mental health research• Collaborative research studies in partnership with

organisations interested in user focused mental health research

• Evaluations and support for organisations to strengthen the evidence-base for different forms of mental health support

• Campaign and policy work to raise the profile of mental health research and improve access to evidence based information

Overview of presentation

1. Introduce the side by side programme

2. Overview of scope of evaluation

3. Qualitative strand of evaluation1. Peer researcher approach

2. Principles and values consultation

3. Capacity building

4. Working with commissioners

4. Next steps

An overview of Side by Side

• To increase peer support market through networking, coaching, mentoring.

• Increase delivery of peer support with strategic partners

• Influence commissioning of community based peer support

• Raise awareness of peer support value

ACTIVE IN 9 REGIONS OF THE COUNTRY

AIMS

Structure of side by side

• 9 regional hubs led by local minds

• Act as a central point for information sharing, networking and support

• 3 strategic partners – MIND, Depression Alliance, and Bipolar UK

• Small grants made to a range of smaller local groups and projects

Side by Side: evaluation partners

3 evaluation partners:

• St Georges University of London

• The McPin Foundation

• London School of Economics

Side by Side: Scope of Evaluation

4 strands to the evaluation:

1. Strand 1 – Assessing the effectiveness of peer support

2. Strand 2 – Conceptualising the principles and values of peer support

3. Strand 3 – Economic evaluation

4. Strand 4 – Working with commissioners

• Co-production built into all stages of qualitative components of SbS evaluation

• Largest qualitative element - exploring core values of peer support in SbS

Aim: Identify core principles and values that work across different approaches to

peer support

Understanding core values in SbSpeer support – co-production

• People with:

Who was involved?

Co-production

Lived Experience mh

difficulties

Experience of sbs peer

support groups

Lived experience peer

support

Academic experience

Lived experience of mh services

Multi stage process:

Qualitative approach

Consultation with people doing peer support at outset of programme

Draft principles and values produced

Interviews with peers involved in the SbS programme

Analysis of interview data and refinement to produce core values

Data collection

Online Survey

(163 people)

Consultation

events

(26 people)

SbS leads: group

interviews

(38 people)

Peer researcher as facilitator and

interviewer

1st draft of values and principles Co-written by qualitative lead and peer researcher

Drafting of initial interview schedules

Initial interviews

Reviewing transcripts re-drafting schedule

Interviews

1st Data analysis - new interview questions*

Final interviews* (total n= 69)

Research team

Peer researchers x4

Research team

Peer researchers x4

Research team

Peer researchers x4

* Overlap with analysis here

Data analysis and final draft core values and key decisions

Transcripts divided between the team and read

Initial group discussions and theme generation, refinement of draft principles and values

Research team including researchers with: • Academic

experience• Lived

experience of mhdifficulties

• Lived experience of peer support

Additional interviews

Further group discussions and further refinement of principles and values – result is ‘Core Values’ and ‘Key Decisions’

Report writing and further refinements

Final ‘Core Values’ and ‘Key Decisions’

Findings

• Identified 6 core values that

underpinned all forms of peer support

• Values in given peer support setting

were shaped by 5 categories practical

people doing peer support were

making

Core Values

Core values

Experience in common• Of mental health difficulties• Of other important personal characteristics or

experiences (e.g. of being a migrant or refugee)

“I don’t know, I just think that it’s comforting to know that all those people are kind of going

through the same thing, just like a little group community, socialise, but also like having that

comfort of knowing that these people are feeling the same way you are.” (group)

Core values

Safety

• Feeling safe in peer support

• The ground rules or structures they decided on that would enable this

• Practical factors (e.g. location of group)

“I think it’s important that everyone is able to trust one another and confidentiality is not broken. Sometimes you can say things that you wouldn’t want the wider

community to know about. It just comes out sometimes. […] In this group, I think people can say

what they want to say without the fear of that coming out.” (group)

Core values

Choice and control

• What kind of peer support to access

• What to share or not share

• Other forms of participation

“I had a lady, she didn’t say anything for four weeks, at all, and I was quite worried about her and sat her down and said, “Is everything okay? […] she went, “Oh, no, I love coming here. It’s ace!” She said, “I just don’t talk much” and she thoroughly enjoyed the mornings. […]

She just, literally, didn’t want to say anything, and that’s fine. As I say, I’ve [also] got talkers in my group

who like to be really involved with everything.” (group)

Core values

Two way interactions

• There is the potential to both give and receive peer support

• Perception of other peers as equals

“My self-esteem is improved. I also like listening to what people have got out of it. I feel useful, for want of

a better word. I feel it's very enjoyable to help other people, it's not at all altruistic. I enjoy feeling worthwhile. I think most people do.” (group)

Core values

Human connection

• Peers are able to make warm, welcoming and genuine supportive connections with each other

“So the support that I’ve had on a personal level has gone beyond just doing activities in a group. It’s

become like a proper family, a proper support for me which has been really important because I do often

doubt whether people like me. I can really have a lot of self-doubt and be very self-critical and think that I’m

not a very likeable person. So to have people reaching out and saying, actually you’re doing okay and you are

a nice person. It makes a huge difference.” (group)

Core values

Freedom to be oneself

• Sense that peers are able to just be themselves in peer support and not have to ‘put on a front’

“[…]when you go into a meeting or you go to have dinner with them or whatever, there are no barriers

there as you already… you know they understand mental health, you know that they’ve gone through

things and they know the same about you. So you don’t have any barriers up, you just feel completely free to

talk about whatever you want. Whereas, with traditional friends, it may take a long time before you

would actually open up about anything that you’re experiencing. (online)

Key Decisions

• Level of facilitation

• Types of leadership

• Focus of peer support ‘sessions’

• Types of membership

• Organisational support

Study limitations

• Completed interviews with a large

number of peers – very few spoke of

negative experiences

• May be missing out on the ‘dark side’

of peer support

Conclusions

• Complicated set of values and key

decisions underpin peer support

• These constructs are interlinked such

that the existence of one value is

dependent on the existence of another