A systematic review of influences on implementation of peer support work for adults with mental health problems

Nashwa Ibrahim, Dean Thompson, Rebecca Nixdorf, Jasmine Kalha, Richard Mpango, Galia Moran, Annabel Mueller‑Stierlin, Grace Ryan, Candelaria Mahlke, Donat Shamba, Bernd Puschner, Julie Repper, Mike Slade

Research output: Contribution to journalArticlepeer-review

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Purpose: The evidence base for peer support work in mental health is established, yet implementation remains a challenge. The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work.

Methods: Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero: CRD42018094838).

Results:The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences.

Conclusion: The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.
Original languageEnglish
Number of pages9
JournalJournal of Social Psychiatry and Psychiatric Epidemiology
Early online date8 Jun 2019
Publication statusE-pub ahead of print - 8 Jun 2019


  • Peer support
  • Consumer–provider
  • Mental health
  • Systematic review
  • Implementation


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