Impact of peer education-supported psychosocial skills training applied to individuals with chronic mental disorderon patients' perceptions of stigma, levels of functionality and insight

The aim of this study was to evaluate the impact of psychosocial skills training supported by peer education on stigma perception, functionality and insight levels of people with chronic mental disorders. The research used an exploratory sequential mixed-methods design, one of the mixed-methods designs in which quantitative and qualitative methods are used together. In the quantitative dimension of the research, a randomised controlled experimental study design was adopted, consisting of a pre-test, interim measurement-1, interim measurement-2, post-test 1, and post-test 2. For the qualitative dimension, a phenomenological study design was adopted. The sample of the study consists of 38 individuals with chronic mental disorders (Experimental group: 19, Control group: 19) who are being followed up at the Pelitköy Community Mental Health Centre in Samsun. The research's data collection process, which comprised of three stages, occurred from 07.07.2023 to 29.09.2023. During the initial stage, the researcher provided eight sessions of 'Peer Education Supported Psychosocial Skills Training - Practitioner Training' to three patients who met the inclusion criteria. In the second stage, the experimental group, determined by randomization, received "Peer Education Supported Psychosocial Skills Training (PE-PST)," consisting of 6 sessions provided by peers who had received practitioner training and were supported by the researcher. The data collection tools used in this process were the 'Introductory Information Form', the 'Self-Stigma Scale (SSS)', the 'Social Functioning Assessment Scale (SFAS)', and the 'Beck Cognitive Insight Scale (BCIS)'.The research process concluded with a semi-structured interview of 12 participants from the experimental group in the third stage of the study. The study's quantitative findings indicate that the training had a significant impact on the SFAS total scores of patients in the experimental group compared to the control group (p < 0.05). Additionally, a significant and large effect was observed at a level of 35.8% (η2 = 0.358; p = 0.005). There was no significant difference between the experimental and control groups in the SSS and BCIS total score averages (p > 0.05). Following semi-structured interviews on the effectiveness of the training, participants' statements were analysed thematically. The analysis resulted in 5 main themes and 24 sub-themes, categorised as 'Peer Support', 'Effective Areas', 'Areas with Limitations of Effectiveness', 'Influencing Factors', and 'Suggestions'. Qualitative and quantitative findings were integrated, and themes were used to support the quantitative findings. The study found that PE-PST had a statistically significant effect on the functional levels of individuals with chronic mental disorders. There was no significant effect on the levels of self-stigma and cognitive insight. However, the training resulted in positive effects on the patients' self-confidence, communication skills, social adaptation, and self-care skills. Additionally, it increased their knowledge and awareness levels regarding chronic mental disorders and experiences of stigma. Based on these results, it is recommended that psychiatric nurses and other mental health professionals develop and integrate peer education-supported interventions, such as peer education-supported psychosocial skills training, into the community mental health system.