The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial

Abstract Introduction Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process. This study aimed to investigate the effectiveness of the ‘Paths to everyday life’ (PEER) intervention, which adds group-based peer support to s...

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Main Authors: Chalotte Heinsvig Poulsen, Cecilie Høgh Egmose, Bea Ebersbach, Carsten Hjorthøj, Lene Falgaard Eplov
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-07011-y
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author Chalotte Heinsvig Poulsen
Cecilie Høgh Egmose
Bea Ebersbach
Carsten Hjorthøj
Lene Falgaard Eplov
author_facet Chalotte Heinsvig Poulsen
Cecilie Høgh Egmose
Bea Ebersbach
Carsten Hjorthøj
Lene Falgaard Eplov
author_sort Chalotte Heinsvig Poulsen
collection DOAJ
description Abstract Introduction Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process. This study aimed to investigate the effectiveness of the ‘Paths to everyday life’ (PEER) intervention, which adds group-based peer support to service as usual (SAU) for individuals with mental health difficulties, compared to SAU alone. Methods A randomized controlled trial in five Danish municipalities compared the PEER intervention added to SAU to SAU alone. Participants were municipality social service users and self-referrals. The primary outcome was personal recovery, measured by Questionnaire about the Process of Recovery (QPR-15) at post-intervention. Intention-to-treat analyses were used for primary and safety outcomes. Results Of the 296 participants included from December 7, 2020, to October 16, 2022, 145 participants received the PEER intervention, and 151 participants received SAU alone. Primary outcome results showed model estimated marginals means in the PEER group [37.3; 95% CI: 35.4 to 39.1] versus SAU alone [32.1; 95% CI: 30.2 to 34.1]. A statistically significant mean difference in QPR-15 scores was seen in the PEER group [5.1; 95% CI: 2.4 to 7.8; p < 0.001] versus SAU alone, corresponding to Cohen’s d of 0.43. No significant between-group differences in hospital admissions or bed days, and no deaths or detectable self-harm were registered during follow-up. Conclusions The primary outcome, personal recovery, showed a significant difference that exceeded the clinically meaningful change, with a small to medium effect size, among adults with mental health difficulties. If the PEER intervention proves cost-effective, implementation in the communities is recommended. Clinical trial registation ClinicalTrials.gov: NCT04639167, registered Nov. 19, 2020, finished May 20, 2024.
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spelling doaj-art-7cc39863f33e464b8a529edd9609d8452025-08-20T04:02:54ZengBMCBMC Psychiatry1471-244X2025-07-0125111210.1186/s12888-025-07011-yThe “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trialChalotte Heinsvig Poulsen0Cecilie Høgh Egmose1Bea Ebersbach2Carsten Hjorthøj3Lene Falgaard Eplov4Copenhagen Research Unit for Recovery, Mental Health Centre Amager, Mental Health ServicesCopenhagen Research Unit for Recovery, Mental Health Centre Amager, Mental Health ServicesCopenhagen Research Unit for Recovery, Mental Health Centre Amager, Mental Health ServicesCopenhagen Research Center for Mental Health (CORE), Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health ServicesCopenhagen Research Unit for Recovery, Mental Health Centre Amager, Mental Health ServicesAbstract Introduction Community-based peer support complements regional mental health services by supporting individuals in their personal recovery process. This study aimed to investigate the effectiveness of the ‘Paths to everyday life’ (PEER) intervention, which adds group-based peer support to service as usual (SAU) for individuals with mental health difficulties, compared to SAU alone. Methods A randomized controlled trial in five Danish municipalities compared the PEER intervention added to SAU to SAU alone. Participants were municipality social service users and self-referrals. The primary outcome was personal recovery, measured by Questionnaire about the Process of Recovery (QPR-15) at post-intervention. Intention-to-treat analyses were used for primary and safety outcomes. Results Of the 296 participants included from December 7, 2020, to October 16, 2022, 145 participants received the PEER intervention, and 151 participants received SAU alone. Primary outcome results showed model estimated marginals means in the PEER group [37.3; 95% CI: 35.4 to 39.1] versus SAU alone [32.1; 95% CI: 30.2 to 34.1]. A statistically significant mean difference in QPR-15 scores was seen in the PEER group [5.1; 95% CI: 2.4 to 7.8; p < 0.001] versus SAU alone, corresponding to Cohen’s d of 0.43. No significant between-group differences in hospital admissions or bed days, and no deaths or detectable self-harm were registered during follow-up. Conclusions The primary outcome, personal recovery, showed a significant difference that exceeded the clinically meaningful change, with a small to medium effect size, among adults with mental health difficulties. If the PEER intervention proves cost-effective, implementation in the communities is recommended. Clinical trial registation ClinicalTrials.gov: NCT04639167, registered Nov. 19, 2020, finished May 20, 2024.https://doi.org/10.1186/s12888-025-07011-yVolunteer-led peer supportCommunityMental health difficultiesPersonal recoveryNon-governmental organization
spellingShingle Chalotte Heinsvig Poulsen
Cecilie Høgh Egmose
Bea Ebersbach
Carsten Hjorthøj
Lene Falgaard Eplov
The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial
BMC Psychiatry
Volunteer-led peer support
Community
Mental health difficulties
Personal recovery
Non-governmental organization
title The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial
title_full The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial
title_fullStr The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial
title_full_unstemmed The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial
title_short The “Paths to everyday life” peer support intervention for adults with mental health difficulties versus service as usual in a Danish community setting – results from a randomized two-armed, multi-site, superiority trial
title_sort paths to everyday life peer support intervention for adults with mental health difficulties versus service as usual in a danish community setting results from a randomized two armed multi site superiority trial
topic Volunteer-led peer support
Community
Mental health difficulties
Personal recovery
Non-governmental organization
url https://doi.org/10.1186/s12888-025-07011-y
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