Recovery through peer support. The effectiveness of a co-produced peer support intervention for community mental health service users - A randomized controlled trial

Research problem and specific questions Peer support (PS) is a well-established intervention within community mental health services (CMHS) internationally, involving a person recovering from serious mental health problems (SMHP) in supporting other users.

International studies have shown that PS strengthen users recovery and social inclusion but also highlight the need for larger effect studies on specific manualized interventions. Despite international research showing benefits of PS in CMHS, PS an underused type of support in Sweden.

There is a urgent need for more Swedish research developing and evaluating the efficacy of PS interventions for persons recovering from SMHP and in shifting Swedish CMHS towards a recovery focussed model of service.

In meeting this need the current project aims to evaluate the efficacy of a new manualized PS intervention, the UPSIDES-Swe, in Swedish CMHS.Is the peer support intervention, UPSIDES-Swe, significantly more effective than TAU at intervention end (10 weeks) in terms of personal recovery (primary outcome)?Is UPSIDES-Swe significantly more effective than TAU post intervention and at three month followups in terms of other personal recovery aspects (secondary outcomes i.e., social inclusion, empowerment, quality of life)?Is the UPSIDES-Swe, significantly more effective than TAU post intervention and at three followups in improving secondary outcomes of clinical recovery related variables, i.e., symptoms and functioning?How well can the implementation plan and UPSIDES-Swe intervention be implemented and processes explained in relation to primary and secondary outcomes?Data and method A randomized, assessor-blinded, multi-center trial will be performed between the years 2025-2028.

A total of 300 service users will be recruited, and half will be randomized to receiving a PS intervention (UPSIDES-Swe) and an equal number to TAU. A process evaluation will also be performed.

Societal relevance and utilization This project will investigate if a specific PS intervention might be effective in providing greater recovery and social inclusion for a disadvantaged and largely neglected group.

The Swedish National Board of Health and Welfare has also recommended that PS is a promising method but that the evidence is weak and that all implementation of PS interventions should be evaluated.

Plan for project realization The previous preparatory studies make the current project feasible, with the RCT being conducted over three years.