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.