Exploring the Role of PSSs in the Delivery of Community-based Mental Health Services (Dec 2011)

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Title: Exploring the Role of Peer Support Specialists in the Delivery of Community-based Mental Health Services
Principal ApplicantTitle(s)Institutional AffiliationFunding AmountAnticipated Completion Date
Dr. Patricia A. Wakefield

Assistant Professor,


Strategic Market Leadership and Health Services Management, DeGroote School of Business at McMaster University

AIC Institute for Strategic Business Studies
$10,000 December 2011
Co-Applicant(s)Titles(s)Institutional Affiliation(s)
Dr. Glen E. Randall

Associate Professor,

Associate Editor,



Strategic Market Leadership and Health Services Management, DeGroote School of Business at McMaster University

Canadian Public Administration

Center for Health Economics and Policy Analysis (CHEPA) at McMaster University

Ontario Training Centre in Health Services and Policy Research

chepa--randall photoBiography of the Principal Investigator:
 Dr. Glen E. Randall is an Associate Professor in Health Policy and Management at the DeGroote School of Business and member of the Centre for Health Economics and Policy Analysis at McMaster University. He holds a PhD in health policy, management and evaluation from the University of Toronto as well as an MBA in health services administration, an MA in public policy and administration, and a BA in political science from McMaster University. Randall has more than 25 years of experience working with leaders in government, regulatory agencies and health care organizations. His research focuses on health system improvements and understanding the impact of reforms on health professionals.  


In the delivery of healthcare services the role of "consumer providers" has taken on an increasing relevance in recent years. These individuals have already experienced specific health challenges and they range from volunteers who provide information about their experiences to paid members of the health care team. One important example of paid consumer providers has been the use of "peer support specialists" in the delivery of community-based mental health services. This role was given a boost when in 1998, the Ontario government formally endorsed use of the Assertive Community Treatment (ACT) program model to provide services to individuals with serious and persistent mental illness. These ACT programs are characterized by multi-disciplinary teams providing services within the community to individuals with the most serious mental illnesses. Under ACT program standards, one of these team members is required to be a "peer support specialist" who is an individual who has received care from an ACT program in the past. The use of peer support specialists in the provision of mental health services is based on the belief that individuals who have experienced, been treated for and overcome serious mental health issues can better understand and relate to the client, and can provide a unique perspective not represented by other members of the service team. While there has been extensive international research into the effectiveness of ACT programs that assess fidelity to standards and clinical outcomes, there is a lack of research to either support or reject the use of peer support specialists. This aim of this study is to explore the role and merit of using peer support specialists within Ontario's ACT programs. This will be done by conducting case studies of four ACT programs. In-depth interviews will be conducted with administrative personnel and detailed surveys with all team members, using a network analytic approach to gain understanding of team dynamics. We will identify how peer support specialists are selected, what services they provide, and the interpersonal communication structure within each team. This study will have broader relevance for situations in which paid "consumer providers" are delivering healthcare services.

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