Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges.
Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges.
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将同伴工人的角色引入英国精神卫生服务团队：对组织福利和挑战的定性分析。
DOI：
10.1186/1472-6963-13-188
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发表时间：
2013-05-24
影响因子：
2.8
通讯作者：
Wright C
中科院分区：
文献类型：
--
作者：
Gillard SG;Edwards C;Gibson SL;Owen K;Wright C
提供同伴支持作为精神卫生保健的一个组成部分，包括精神卫生服务组织雇用同伴工作者（消费者-提供者），在国际上越来越普遍。在英国的一些卫生和社会保健政策中，大力提倡同伴支持作为一种战略。雇用同伴工作者的方法正在激增。有证据表明，同伴工作者为基础的干预措施，减少精神病住院治疗，并增加服务用户（消费者）的权力。在本文中，我们试图解决的差距，在了解组织的挑战和好处，引入同行工作者的角色到心理健康服务团队的实证文献。我们报告的定性访谈数据的二次分析，从服务用户，同行工作者，非同行工作人员和管理人员的三个创新的干预措施，在一项关于心理健康自我保健的研究。相关的数据是从与41名参与者的访谈中提取的，并使用扎根理论技术进行分析。组织研究文献的角色采用框架的分析。同伴工作者受到心理健康团队和服务用户的高度重视。非同级团队成员和管理人员努力将同级员工引入团队。我们的案例是正在开发中的项目，并从演变过程中吸取了教训：在没有正式的同行工作者招聘流程的情况下，对同行工作者角色的期望差异可能会在选择阶段出现;同行工作者的灵活工作安排可能会产生意想不到的效果，使团队内的等级制度永久化;通过监督和培训维持保护性做法的界限可能会妨碍出现一个独特的同侪做法;缺乏关于什么是同伴实践的共识可能会导致同伴工作者感到不平等、权力被剥夺、身份不确定和支持不足。这项研究表明，心理健康服务团队引入同伴工作者角色的潜在好处。分析还表明，如果没有充分考虑和支持一个独特的同行实践机构的出现，作为发展新的同行工作者角色的组成部分，那么任何新兴角色的潜在影响都有可能受到限制和稀释。
The provision of peer support as a component of mental health care, including the employment of Peer Workers (consumer-providers) by mental health service organisations, is increasingly common internationally. Peer support is strongly advocated as a strategy in a number of UK health and social care policies. Approaches to employing Peer Workers are proliferating. There is evidence to suggest that Peer Worker-based interventions reduce psychiatric inpatient admission and increase service user (consumer) empowerment. In this paper we seek to address a gap in the empirical literature in understanding the organisational challenges and benefits of introducing Peer Worker roles into mental health service teams. We report the secondary analysis of qualitative interview data from service users, Peer Workers, non-peer staff and managers of three innovative interventions in a study about mental health self-care. Relevant data was extracted from interviews with 41 participants and subjected to analysis using Grounded Theory techniques. Organisational research literature on role adoption framed the analysis. Peer Workers were highly valued by mental health teams and service users. Non-peer team members and managers worked hard to introduce Peer Workers into teams. Our cases were projects in development and there was learning from the evolutionary process: in the absence of formal recruitment processes for Peer Workers, differences in expectations of the Peer Worker role can emerge at the selection stage; flexible working arrangements for Peer Workers can have the unintended effect of perpetuating hierarchies within teams; the maintenance of protective practice boundaries through supervision and training can militate against the emergence of a distinctive body of peer practice; lack of consensus around what constitutes peer practice can result in feelings for Peer Workers of inequality, disempowerment, uncertainty about identity and of being under-supported. This research is indicative of potential benefits for mental health service teams of introducing Peer Worker roles. Analysis also suggests that if the emergence of a distinctive body of peer practice is not adequately considered and supported, as integral to the development of new Peer Worker roles, there is a risk that the potential impact of any emerging role will be constrained and diluted.
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