Review Supports One-to-One Peer Mentorship among Veterans
The term post-deployment syndrome (PDS) was recently coined to characterize the combinations of physical, psychological, and social difficulties frequently encountered by Veterans returning from combat in Iraq and Afghanistan. Peer-based programs have been initiated within the Armed Forces and as a means to identify Veterans at risk and counteract stigma that Veterans may feel is associated with seeking help for some of these problems. Peer programs may also offer a means to improve access to healthcare treatment and adherence. In 2011, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury released a White Paper titled "Identification of Best Practices in Peer Support." This review sought to complement the White Paper by identifying and describing one-to-one peer mentorship (PM) programs, identifying elements associated with positive outcomes that are relevant to Veterans with PDS, and summarizing current practice in a way that informs the development of programs for Veterans. Investigators conducted a "scoping" review focused on literature published between 1980 and 2012 and identified 18 relevant articles. Unlike a systematic review or meta-analysis, a scoping study does not include evaluating the strength or quality of the empirical evidence.
- Across a broad range of populations, peer mentors appeared to be acceptable, credible sources of information. This may be particularly true among current and former members of the Armed Forces, who are accustomed to a culture of mutual support.
- The literature suggests that peers are capable of conducting assessment and triage, coaching and teaching, and providing direct social support.
- The White Paper identified three areas where peer mentorship (PM) might play a unique role for military/Veteran populations: coping with combat and operational stress, suicide prevention, and recovery-related issues downstream from combat/injury. In addition, the scoping review suggests PM might play a role in reducing stigma, improving treatment adherence, increasing knowledge of treatment resources, and augmenting or teaching self-management skills.
- A small portion of PM participants (5%-10% of participants in three studies) noted adverse effects associated with PM interventions.
IMPLICATIONS and FUTURE RESEARCH:
Findings indicate that further research is essential as PM programs continue to be developed and implemented. The authors suggest that VA/HSR&D's Quality Enhancement Research Initiative (QUERI) provides an ideal infrastructure for this research. Specific research priorities to be considered are: 1) identification of the most productive applications of PM for Veterans returning from OEF/OIF; 2) development of empirically supported one-to-one PM interventions for Veterans; 3) exploration of how to incorporate PM interventions into the clinical setting; 4) identification of best ways to collaborate with Veteran-oriented organizations (e.g., Wounded Warriors) to incorporate empirical evaluations into existing programs; and 5) development of similar mentorship programs for family members of Veterans.
This study was funded through VA/HSR&D's Polytrauma and Blast-Related Injuries Quality Enhancement Research Initiative (PT/BRI-QUERI; RRP 07-289 and RRP 09-134).
Williams R, Bambara J, and Turner A. A Scoping Study of One-to-One Peer Mentorship Interventions and Recommendations for Application with Veterans with Post-Deployment Syndrome. Journal of Head Trauma Rehabilitation July-Aug 2012;27(4):261-73.