Depression/Bipolar Peer Support Groups: Perceptions of Group Members about Effectiveness and Differences from Other Mental Health Services

Peer support services remain poorly understood by many mental health service providers. In this study we explored the views of people who use peer led support groups. We asked how adding peer support groups changed, balanced, or augmented the use of conventional mental health services. Participants were 43 adults attending 4 peer led support groups for depression/bipolar disorder. Data consisted of observations of all 43 participants interacting in their group, in-depth interviews of 20 participants, and results from 2 standardized questionnaires to ballpark the level of symptom severity relative to other groups. Through constant comparative analysis, 12 categories emerged. The most salient features of our findings consisted of the shared perception that groups promoted recovery and augmented conventional services. Members felt acceptance due to their shared diagnoses. Groups provided an experience of community in which recovery skills could be practiced, practical advice received, and hope and empowerment encouraged. Groups appeared to provide participants with important support and healing unavailable from psychotherapy and psychiatry. Peer support groups appeared to be an important addition and sometimes an adequate substitute for psychotherapy and/or psychiatry. Further research is indicated and quantitative students should build on the insights of qualitative studies in developing their protocols. Keywords: Peer Support, Bipolar Disorder, Depression, Group Psychotherapy, Peer Counseling, Mood Disorders, Grounded Theory, Constant Comparative Analysis, Mutual Aid Consumer-operated or peer-led programs consist of groups of people with similar problems who come together in places they own and control to learn from each other without experts (Chamberlin, Rogers, & Ellison, 1996; Davidson, Chinman, Kloos, Weingarten, Stayner, & Tebes, 1999; Lieberman & Snowden, 1994). Consumer-operated programs are not clinical treatment and tend to use the language of recovery more than that of maintenance (Davidson et al., 1999). Consumer groups such as Mental Health America, National Alliance for Mental Illness, and the Depression Bipolar Support Alliance (DBSA) recommend support groups in addition to other services for mood disorders (Depression Bipolar Support Alliance, 2012; Mental Health America, 2011; National Alliance on Mental Illness, 2012). The Substance Abuse and Mental Health Services Administration promotes peer support (SAMHSA, 2004). "The American Psychiatric Association recognizes, supports and promotes peer support services as an important part of the continuum of mental health and substance use disorder services" (American Association of Community Psychiatrists, 2010). Peer support comes in many forms. Davidson et al. (1999) have described three types of peer support: informal (naturally occurring), peers participating in peer/consumer run programs, and consumers employed as peer providers (Peer Support Workers [PSWs] or Peer Specialists). Repper and Carter (2011), in a review of 38 studies published between 1995 and 2010 on peer support in mental health services, identify the growth of the employment of PSWs in the US, Australia, and New Zealand over the last decade, and more recently in the UK. The idea of recovery has been intimately linked to peer support and came to the forefront when The President's New Freedom Commission recognized it as an essential focus of service programs for persons with serious mental illness (Hogan, 2003; New Freedom Commission on Mental Health, 2003). Services that promote recovery and include the person with disabilities in all facets of intervention appear to yield greater success in helping people to meet their vocational and independent living goals (Corrigan, Faber, Rashid, & Leary, 1999; Rogers, Chamberlin, Ellison, & Crean, 1997). Peer-support, peer-counseling, and consumeroperated services are considered integral to the recovery process (Corrigan, Calabrese, Diwan, Keogh, Keck, & Mussey, 2002) and appear to facilitate recovery from serious mental illness (Corrigan, Slopen, Gracia, Keogh, & Keck, 2005). …