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