Background
Phase | Process | Participant | Stakeholder |
---|---|---|---|
Phase I: Training for peer support workers | 1. Organizing 2 focus group sessions to discuss and decide on the curriculum content | • 8 individuals currently participating in supported employment | • 1 psychiatrist • 2 psychologists • 1 psychiatric nurse • 1 social worker • 1 case manager • 1 occupational therapist |
2. The curriculum includes 12 h each of lecture &practice (2 h in total of lecture & practice per week, for 12 weeks) | |||
Phase II: Extended vocational rehabilitation co-led & assisted by peer support workers | 1. Assessing, by using questionnaires, the social support received by service users, their mental health, psychiatric symptoms and functioning, as well as collecting data of earned (weekly) income and working hours by service users before the intervention | • 6 of 8 peer support workers who completed training and decided to proceed to Phase II of the program • 46 service users currently participating in sheltered or supported employment | • 2 occupational therapists |
2. Peer support workers as coleaders to train service users for workplace problem-solving (1.5 h every 2 weeks, 8 sessions in total) | |||
3. Peer support workers as assistants in care skills training (2 h per week, for 16 weeks) | |||
Post-intervention follow-up | 1. Assessing, by using questionnaires, the social support received by service users, their mental health, psychiatric symptoms and functioning, as well as collecting data of earned (weekly) income and working hours by service users after the intervention | • 42 service users completed the extended vocational rehabilitation program | • None |
Withdrawals: • 1 service user getting improved skills to care her elderly mother with disability at home • 1 service user suffering acute psychosis • 2 service users failing to meet the threshold of attendance rate of 80% |
Methods
Participants
Pilot program
Training for peer support workers
Intervention level | Themes of curriculum | ||||
---|---|---|---|---|---|
We need peer support | Be healthier and happier | My recovery journey | Recover together | Work together | |
Community | Introducing the People with Disabilities Rights Protection Act in Taiwana | Using resources in communities to cultivate independent living skills, better health, and to find a jobc | |||
Dealing with discrimination encountered in communitiesa | |||||
Service system | Connecting with other peopleb | Mental health &mental health promotiona | Concepts of recovery & empowerment at both individual &service team levelsa | Coleading workplace problem-solving groupb | |
Treatment & rehabilitation in mental health servicesa | Roles of trained professionals with different specialties &peer support workers in mental health servicesa | Assisting the vocational rehabilitation trainingb | |||
Individual | What is the job of peer support workers? a | Cooperating with care-givers and/or trained professionals with different specialtiesb | Principle of self-determinationa | Skills of active listeninga | Leadership in a groupa |
My life storya | Recognizing critical time pointsb | Sharing the decisions made during my own vocational journeya | |||
My experience of managing my own mental illnessb | Illustrating my recovery story through role-playingc | Acquiring interviewing skills through simulationsc |
The extended vocational rehabilitation services co-led & assisted by peer support workers
Measurements
Social support
Mental health and psychiatric symptoms
Social function
Earned income from employment
Process of assessment
Statistical methods
Results
Characteristics of service users
Characteristics | N = 46 | |
---|---|---|
Demography | n | (%) |
Age (mean ± SD) | 49.1 | ± 9.8 |
Sex | ||
Male | 27 | (58.7) |
Female | 19 | (41.3) |
Years of education | ||
6 years | 3 | (6.5) |
7–9 years | 10 | (21.7) |
10–12 years | 13 | (28.3) |
> 12 years | 20 | (43.5) |
Marital status | ||
Single | 44 | (95.7) |
Married | 2 | (4.3) |
Housing | ||
Halfway house | 34 | (73.9) |
Supported housing program | 12 | (26.1) |
Social welfare | ||
Disability welfare | 35 | (76.1) |
Exemption from copayment of health insurance | 25 | (54.3) |
Low-income subsidy | 14 | (30.4) |
Monthly incomea | ||
< 100 USD | 24 | (52.2) |
100–199 USD | 7 | (15.2) |
200–299 USD | 6 | (13.0) |
300–399 USD | 4 | (8.7) |
> 400 USD | 5 | (10.9) |
Kinds of job | ||
Cleaner | 11 | 23.9 |
Manpower dispatch | 9 | 19.6 |
Porter | 6 | 13.0 |
Care attendant | 4 | 8.7 |
Assistant | 4 | 8.7 |
Cooker | 4 | 8.7 |
Othersb | 8 | 17.4 |
Physical comorbidity | 30 | (65.2) |
Psychiatric history | ||
Age of onset (mean ± SD) | 25.3 | ±8.8 |
Years of hospitalization (median (25–75%til)) | 8.0 | (4.0–13.3) |
History of violence or suicide attempt | 19 | (41.3) |
Pre- vs. post-intervention of peer co-delivered services
Pre-intervention | Post-intervention | df | t | P value | |||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | ||||
SSS | 149.1 | 31.8 | 161.2 | 35.0 | 41 | 2.70 | 0.01* |
SSS-R | 49.2 | 14.4 | 51.0 | 14.3 | 41 | 1.02 | 0.32 |
SSS-S | 55.5 | 13.0 | 57.8 | 13.9 | 41 | 1.63 | 0.11 |
SSS-F | 44.4 | 12.0 | 53.2 | 13.2 | 41 | 4.72 | < 0.001* |
CHQ-12 | 3.1 | 2.6 | 2.8 | 2.5 | 41 | −1.08 | 0.29 |
BPRS-18 | 31.2 | 6.7 | 29.3 | 5.0 | 41 | −2.83 | 0.007* |
GAF | 69.8 | 9.8 | 72.6 | 8.8 | 41 | 3.50 | 0.001* |
C-SFS | 75.2 | 8.8 | 78.1 | 9.5 | 41 | 2.59 | 0.01* |
Weekly working hours | 20.0 | 7.6 | 21.9 | 8.7 | 41 | 1.72 | 0.09 |
Weekly Income (USD) | 37.5 | 35.5 | 43.6 | 38.0 | 41 | 2.57 | 0.01* |