Peer support for people with severe mental illness versus usual care in high-, middle- A nd low-income countries: Study protocol for a pragmatic, multicentre, randomised controlled trial (UPSIDES-RCT)

Galia S. Moran, Jasmine Kalha, Annabel S. Mueller-Stierlin, Reinhold Kilian, Silvia Krumm, Mike Slade, Ashleigh Charles, Candelaria Mahlke, Rebecca Nixdorf, David Basangwa, Juliet Nakku, Richard Mpango, Grace Ryan, Donat Shamba, Mary Ramesh, Fileuka Ngakongwa, Alina Grayzman, Soumitra Pathare, Benjamin Mayer, Bernd Puschner

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background: Peer support is an established intervention involving a person recovering from mental illness supporting others with mental illness. Peer support is an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including service user outcomes (psychosocial and clinical), peer support worker outcomes (work role and empowerment), service outcomes (cost-effectiveness and return on investment), and implementation outcomes (adoption, sustainability and organisational change). Methods: UPSIDES-RCT is a pragmatic, parallel-group, multicentre, randomised controlled trial assessing the effectiveness of using peer support in developing empowering mental health services (UPSIDES) at four measurement points over 1 year (baseline, 4-, 8- A nd 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- A nd low-income countries (Germany, UK, Israel, India, Uganda and Tanzania). The primary outcome is social inclusion of service users with severe mental illness (N = 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (using the Empowerment Scale), hope (using the HOPE scale), recovery (using Stages of Recovery) and health and social functioning (using the Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect and the implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. Discussion: The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centredness, community participation and the realisation of mental health as a human right.

Original languageEnglish
Article number371
JournalTrials
Volume21
Issue number1
DOIs
StatePublished - 1 May 2020

Keywords

  • Cost-effectiveness analysis
  • Global mental health
  • Implementation science
  • Peer support
  • Pragmatic randomised controlled trial
  • Process evaluation
  • Severe mental illness

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)

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