Peers and Co-Occurring Research-Supported Interventions.

OBJECTIVE

Adults with co-occurring mental illness and substance use disorders have poor outcomes in important quality of life areas, including hospitalization, incarceration, employment, and community housing. Integrated dual disorder treatment (IDDT) is a research-supported intervention for individuals with co-occurring disorders associated with improvements in outcome measures when implemented with high fidelity. Research-supported intervention IDDT was not designed with peer services, provided by people with lived experience with mental illness, but the practice has been altered to include peers.

METHODS

IDDT fidelity data were evaluated from 20 teams that also reported on peer services on their team in one state over a 7 year period, and paired with their fidelity data for the most recent review to analyze the relationship between peers and IDDT fidelity. Analysis of variance was utilized to determine a dose effect peers on fidelity.

RESULTS

Of these IDDT teams, 85% of teams incorporated a peer and 40% of teams had a full-time peer. Having a full-time peer (M = 4.22, SD = .41) was associated with significantly higher fidelity compared to teams with a part-time (M = 3.68, SD = .56) or no peer (M = 3.21, SD = .18, F(2, 17) = 5.88, p = .01).

CONCLUSIONS

Peers on IDDT teams are associated with higher fidelity, leading to important possibilities about the incorporation of those with lived experience into research-supported interventions. Implications for team composition, implementation measurement, policy, and funding are discussed.