Peer Support Programs for Youth Mental Health

Key Messages

• We conducted a Health Technology Assessment (HTA) to inform decisions related to the adoption, implementation, and evaluation of peer support programs for youth mental health. This HTA consisted of consultations with youth advisors (peer support users and workers), a systematic review of the available evidence on the clinical effectiveness and safety of peer support interventions for youth with mental health concerns (compared with interventions without peer support), and an Environmental Scan of peer support program evaluations.
• Youth recognize the value of peer support in their mental health recovery and wellness, and they view peer support as an accessible, convenient, and safe mental health resource. They also highlight the importance of representation and involvement of youth with diverse backgrounds and experiences across the design and evaluation of peer support programs to ensure equity, diversity, and inclusion.
• In the Clinical Review, we found that formal peer support programs (i.e., trained peer support workers based at structured community- or health clinic–based organizations provide support to peer support users) might help a young person feel more comfortable to share information about their mental health issue and ask for help. The authors of 2 randomized controlled trials we identified found that compared to no peer support, peer support may improve youth’s attitudes toward disclosure of mental illness, distress related to that disclosure, and help-seeking behaviour. However, overall, only a small amount of low-quality evidence (due to risk of bias, inconsistency, indirectness, and imprecision) is available. Therefore, it is very uncertain whether peer support programs are more effective at supporting an individual in their recovery compared to programs without a peer support component. In addition, the safety of peer support programs is currently unknown (no research evidence was found).
• Our Environmental Scan did not identify formal guidelines or best practices for evaluating peer support programs; however, we found some common evaluation approaches among programs. These approaches include focusing on recovery-oriented outcomes, involving youth throughout the evaluation (to ensure relevance), and tailoring the evaluation to reflect the local program context.
• When considering implementation of peer support programs for youth mental health, decision-makers may wish to allocate resources for ongoing program evaluation. Strengthened program evaluations can improve the understanding of the benefits and maximize the effectiveness of peer support programs. In addition, practice-based evidence from the evaluation of peer support programs can be used to further support the design and implementation of appropriate, equitable, and culturally competent programs.