Project summary

OPAL aimed to develop and trial a one-to-one peer support programme for relatives/ friends of people treated under the Mental Health Act (MHA) in England. This programme was adapted from a programme in Germany (the EX-IN programme) which reduced caregiving stress and improved carers’ quality of life.

For OPAL, peer supporters were trained to support carers who currently had someone being treated under the MHA. Peers would support carers for up to three months. After receiving this support, carers reported reduced caregiving burden and increased mental health-related quality of life. Carers also commended the programme’s flexible delivery and content, and valued the inside knowledge and deeper understanding those who had shared experiences could provide.

Background

Relatives/friends of people who are treated under the MHA (carers) report a high level of stress, feelings of isolation and exclusion from their patient’s care. If left without support, carers are at an increased risk of developing diagnosable physical and mental health disorders. The 2018 MHA review recognised carers’ need for support during this difficult time and recommended they be supported. One-to-one peer support is widely implemented and effective at facilitating mental health recovery for patients. Initial evidence reports that peer support may benefit carers too, but a one-to-one peer support programme to help carers in England had not been developed, which OPAL aimed to address.

Aims

• To adapt a one-to-one peer support programme for relatives/ friends (carers) of people treated under the MHA for delivery in England.
• To test the feasibility, acceptability and costs of delivering a one-to-one peer support programme for carers in England.

Research Team

Chief Investigator: Professor Domenico Giacco

Giacco is a professor at Warwick Medical School with experience in conducting research on social networks and online networking of people with severe mental illness. He has overall responsibility for the completion of the programme including the trial, and directly managing the research staff.

Co-Lead: Professor Stefan Priebe

Priebe is a senior professor at the department of psychiatry and psychotherapy at the University of Hamburg. Priebe provides research expertise, support and guidance throughout the study.

Study Co-Ordinator: Dr Imogen Wells

Wells is a postdoctoral research fellow at Warwick Medical school who has experience conducting mixed methods studies around intervention development and testing. She is responsible for the day-to-day management of the project.

Research Assistant: Ms Kelly Wintsch (until August 2024)

Wintsch is a Psychology graduate. She assisted in the conduct of the research including the collection and analysis of data.

Research Assistant: Ms Abigail G-Medhin (until August 2022)

G-Medhin is a Biomedical Science graduate with research assistant experience in Population Health. She assisted in the conduct of the research, including the collection and analysis of data.

Outputs

When developing the peer support programme we found, through interviews with stakeholders including carers, that these carers had received inconsistent and unstructured support. Carers wanted a continuous contact with lived experience (peer) to offer information and support (Wells et al, 2024). These stakeholders also highlighted the need for interactive training for peers and flexible delivery of support to fit carers’ needs and circumstances.

A training manual for peer supporters was developed from these findings, which will be made freely available shortly. This training manual guided the delivery of an interactive training programme for peer supporters. Peers reported that the programme helped them feel equipped and confident to support carers.

Carers who received peer support reported a significant reduction in caregiving burden and depression as well as a significant increase in mental health-related quality of life. They also felt better equipped to communicate effectively with professionals and become more involved in their patient’s care. These results are currently being written into an academic paper. A technical guide detailing recommendations for policy makers and a guidance for interested carers are also being created and will be available to access here once complete.

The OPAL project was led by the Coventry and Warwickshire Partnership NHS Trust (CWPT) and the University of Warwick. The work for this project was carried out at CWPT, East London NHS Foundation Trust (ELFT), Devon Partnership Trust (DPT) and Herefordshire and Worcestershire Health and Care Trust (HWHCT).

The OPAL project involved collaborative work engaging various stakeholders, including carers, service users and health and social care professionals.