Employment as a Peer Support Technician: Impact on Mental Health Recovery

描述(由申请人提供)： 背景：VHA正在改革其精神卫生保健系统。作为这一转变的一部分，已承诺投入大量资源，将同伴提供者作为同伴支助技术员和同伴职业康复专家纳入现有的精神健康服务。康复模式，特别是帮手治疗原则，假定雇用同伴专家不仅有利于服务的接受者，而且有利于提供者本身。目前，由艾森博士领导的一项随机试验正在研究参与同伴支持计划对参与者心理健康康复结果的影响。然而，很少有研究考察作为一名同伴提供者对处于同伴提供者职位的退伍军人的心理健康、功能和社区融合的影响。现有的文献集中于同行提供者培训计划的结果，以及作为同行提供者的个人账户。目前还没有系统的经验证据表明，作为同行专家的工作对他们自己的康复有什么影响。这将是第一次研究同行专家的心理健康恢复结果。目前雇用同伴支持技术员提供了一个独特的机会，可以系统地检查担任同伴提供者角色的退伍军人的心理健康和社区功能。目标：1)检查退伍军人管理局专科医生的工作职能、职责、经历、寿命、自我感觉的工作表现和满意度：2)检查专科医生的心理健康恢复情况，包括症状和功能、住房和生活质量，并将其与CWT参与者的样本进行比较；3)检查一年内工作绩效和心理健康/恢复情况的变化；以及4)确定与一年期间的工作相关和心理健康/恢复结果相关的因素。尽管我们并不指望被聘为同伴支持技术员的退伍军人和被聘为职业康复顾问的退伍军人的结果会有所不同，但第五个探索性目标将是确定在这两个倡议下聘用的退伍军人之间的结果是否存在差异。方法：将通过电子邮件或电话邀请所有目前受雇的同伴支持技术员和退伍军人作为无家可归退伍军人倡议下的职业康复专家参与这项研究，并邀请300名参加补偿工作疗法(CWT)的对照组参与这项研究。这项研究的邀请函将提供有关目的和程序的基本信息，并将提供到调查网站的链接。此外，还将包括一份资料表，提供将包括在书面同意书中的所有信息。我们将使用定量和定性的方法，包括可靠和有效的心理健康、康复和工作表现的衡量标准。个人层面的数据将通过问卷获得，在登记参加研究时以及六个月和一年后通过安全网站进行管理。将对研究参与者进行半结构化电话采访，以获得关于他们工作的深入信息，特别强调了解如何以最佳方式利用他们的技能和经验来为他们正在工作的计划做出贡献，并最大限度地提高他们对退伍军人(包括他们提供服务的人和他们自己)的心理健康的影响。预期影响：拟议的研究将提供关于以下方面的系统信息：1)作为同行专家对退伍军人的心理健康、康复、功能和社区融合的影响，包括担任同行专家的住房稳定性；2)如何加强同行专家的作用，以最大限度地发挥他们在退伍军人精神卫生保健提供系统中的价值。我们所获得的知识将有助于指导VHA进一步实施同行支持服务。

DESCRIPTION (provided by applicant): Background: The VHA is in the process of transforming its mental health care system. As part of this transformation significant resources have been committed to integrating peer providers into existing mental health services both as peer support technicians and as peer vocational rehabilitation specialists. Recovery models and specifically the helper therapy principle, postulate that employment as a peer specialist benefits not only the recipients of services, but also the providers themselves. A current randomized trial led by Dr. Eisen is examining the impact of participating in a peer support program on mental health recovery outcomes of participants. However, there is very little research examining the impact of being a peer provider on the mental health, functioning and community integration of veterans in peer provider positions. The existing literature focuses on outcomes of peer provider training programs, and on personal accounts of being a peer provider. There is currently no systematic empirical evidence regarding the impact of working as a peer specialist on their own recovery. This will be the first study to examine mental health recovery outcomes of peer specialists. The current employment of peer support technicians offers a unique opportunity to systematically examine the mental health and community functioning of veterans working in peer provider roles. Objectives: Objectives are to: 1) examine job functions, responsibilities, experiences, longevity, self- perceived job performance and satisfaction of peer specialists in VA: 2) examine mental health recovery including symptoms and functioning, housing and quality of life in peer specialists and compare them to a sample of CWT participants; 3) examine change in job performance and mental health/recovery over one-year; and 4) identify factors associated with job-related and mental health/recovery outcomes over a one-year period. Although we don't expect the veterans employed as peer support technicians and those hired as vocational rehabilitation counselors to differ in their outcomes, a fifth exploratory aim will be to determine whether there are differences in outcomes between those hired under these two initiatives. Methods: All currently employed peer support technicians and veterans hired as vocational rehab specialists under the Homeless Veterans initiative will be invited to participate in the study by email or by telephone, as will a comparison group of 300 Compensated Work Therapy (CWT) participants. The invitation to the study will provide basic information about the purposes and procedures, and will provide a link to the survey web site. In addition, an information sheet providing all the information that would be included in a written consent form will be included. We will use quantitative and qualitative methods including reliable and valid measures of mental health, recovery and job performance. Individual level data will be obtained by questionnaires to be administered via a secure website upon enrollment in the study and six months and one year later. Semi- structured telephone interviews will be conducted on a subsample of study participants to obtain in depth information about their jobs with specific emphasis on understanding how their skills and experience can be optimally used to contribute to the program in which they are working, and to maximize their impact on veterans' mental health (both those to whom they provide services, and to themselves). Anticipated Impacts: The proposed research will provide systematic information about 1) the impact of being a peer specialist on the mental health, recovery, functioning and community integration including housing stability of veterans serving as peer specialists; and 2) how to enhance the roles of peer specialists to maximize their value in the VA mental health care delivery system. The knowledge we gain will be helpful for guiding further implementation of peer support services in the VHA.