peer recovery; substance use; peer; treatment; literature review
Background: In the United States, the need for mental health and substance misuse treatment has been on the rise leading to an increase in healthcare costs and a reduction in barriers to care. Recently, there has been a growing interest in implementing peer support services (PSS) to increase access to care, improve treatment outcomes, and reduce healthcare related costs, such as emergency room visits, psychiatric hospitalization, and crisis stabilization.
Aims: This Honors project reports on a systematic review of the literature on treatment outcomes associated with PSS in mental health and/or substance misuse populations. It reviews the evidence that PSS may reduce healthcare related costs associated with these two populations. The second aim of this study is to identify potential gaps in the literature and make recommendations for future research.
Methods: Relevant publications were identified via a comprehensive keyword search on the PubMed database. Treatment outcomes on mental health and substance misuse populations, as well as healthcare costs were outcomes of interest. This study followed Khan et al. (2003)’s framework for conducting systematic literature reviews, including the use of quality assurance measure. Four types of studies were included: randomized controlled trials, quantitative studies, longitudinal studies, and population-based studies.
Results: A total of 609 articles were identified and 19 articles met inclusion criteria and were selected for review. There were 15 articles on mental health treatment outcomes, one on substance misuse treatment outcomes, and five on impacts to healthcare cost. There were two articles that covered both mental health treatment outcomes and another outcome. Eleven articles on mental health reported significant improvements in mental health outcomes and/or reductions in symptoms. The one article on substance misuse found a significant increase in outpatient service engagement in the short term and a greater sustained reduction in alcohol use long term. Three articles on healthcare cost found no significant reduction in healthcare related cost, with one study finding significant increases in outcomes associated with healthcare cost.
Conclusions: PSS have the potential to increase mental health and substance use treatment outcomes. This study did not find evidence that PSS reduce healthcare related costs. Gaps are identified in the literature on substance misuse treatment outcomes and healthcare related costs.