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A Cluster Randomized Trial of Adding Peer Specialists to Intensive Case Management Teams in the Veterans Health Administration

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An Erratum to this article was published on 12 November 2013

Abstract

Use of peer specialists (PSs)—individuals with serious mental illness who use their experiences to help others with serious mental illness—is increasing. However, their impact on patient outcomes has not been demonstrated definitively. This cluster randomized, controlled trial within the Veterans Health Administration compared patients served by three intensive case management teams that each deployed two PSs for 1 year, to the patients of three similar teams without PSs (Usual Care). All patients (PS group = 149, Usual Care = 133) had substantial psychiatric inpatient histories and a primary Axis 1 psychiatric disorder. Before and after the year PSs worked, patients were surveyed on their recovery, quality of life, activation (health self-management efficacy), interpersonal relations, and symptoms. Patients in the PS group improved significantly more (z = 2.00, df = 1, p = 0.05) than those receiving Usual Care on activation. There were no other significant differences. PSs helped patients become more active in treatment, which can promote recovery.

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Acknowledgments

Financial support for the paper was provided by a grant from the Department of Veterans’ Affairs Health Services Research and Development, PEers Enhancing Recovery (PEER, IIR 06–227). All authors do not have any conflict of interests to report. The contents do not represent the views of the Department of Veterans Affairs or the US Government. Dr. Chinman had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of Interest Statement

All the authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. VISN-4, VA Pittsburgh Healthcare, Mental Illness Research, Education, and Clinical Center, Pittsburgh, PA, USA

    Matthew Chinman PhD

  2. RAND Corporation, VA Healthcare System, 7180 Highland Drive (151-R), Pittsburgh, PA, 15206, USA

    Matthew Chinman PhD

  3. VA Desert Pacific Mental Illness Research, Education, and Clinical Center, West Los Angeles VA Healthcare System, MIRECC, 11301 Wilshire Blvd., 210A, Los Angeles, CA, 90073, USA

    Rebecca S. Oberman MA

  4. Center for Health Equity Research and Promotion (CHERP) and MIRECC, VA Pittsburgh Healthcare, Pittsburgh VA, 7180 Highland Drive, Pittsburgh, PA, 15206, USA

    Barbara H. Hanusa PhD

  5. Health Services Unit, VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA

    Amy N. Cohen PhD

  6. Department of Psychiatry and Biobehavioral Science, UCLA, West Los Angeles VA Healthcare System, MIRECC, 11301 Wilshire Blvd., 210A, Los Angeles, CA, 90073, USA

    Amy N. Cohen PhD

  7. Department of Psychology, IUPUI School of Science (LD), Indiana University Purdue University Indianapolis, 402 N Blackford Street, LD126B, Indianapolis, IN, 46202-3275, USA

    Michelle P. Salyers PhD

  8. Neuropsychology Unit, Center of Excellence, VA San Diego Healthcare System, San Diego, CA, USA

    Elizabeth W. Twamley PhD

  9. University of California, San Diego, 140 Arbor Drive (0851), San Diego, CA, 92103, USA

    Elizabeth W. Twamley PhD

  10. Health Services Unit, VA Desert Pacific Mental Illness Research, Education and Clinical Center, Los Angeles, CA, USA

    Alexander S. Young MD

  11. West Los Angeles VA Healthcare System, MIRECC, 11301 Wilshire Blvd., 210A, Los Angeles, CA, 90073, USA

    Alexander S. Young MD

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  1. Matthew Chinman PhD
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  2. Rebecca S. Oberman MA
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  5. Michelle P. Salyers PhD
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  7. Alexander S. Young MD
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Correspondence to Matthew Chinman PhD.

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Chinman, M., Oberman, R.S., Hanusa, B.H. et al. A Cluster Randomized Trial of Adding Peer Specialists to Intensive Case Management Teams in the Veterans Health Administration. J Behav Health Serv Res 42, 109–121 (2015). https://doi.org/10.1007/s11414-013-9343-1

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