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.