The impact of context on mental health peer support work: ethnographic study

同伴支持工作者（PSWs）是在公共和志愿部门心理健康设置中以同伴支持能力雇用的有心理健康问题生活经历的个人。公共安全工作者是卫生部劳动力的重要组成部分（卫生部，2007年）。然而，在高度标准化的组织环境中的能力可能会对PSW角色施加限制，限制其有意义地影响MH系统的能力（Gillard等人，2014）。这个项目将探讨如何在两个不同的MH设置PSW的作用是实施特别关注PSW和组织文化之间的关系。使用结构化理论，我将探讨社会结构（MH组织，规则，资源）如何约束和塑造个人机构（PSW的行动和行为），这反过来又有助于（重新）生产和塑造结构。通过将结构分为三种形式：支配，意义化和合法化，将更好地理解PSW如何谈判复杂的心理健康结构系统（Giddens，1979）。一个比较民族志的案例研究方法将被用来解决以下两个问题：（1）在什么样的方式做的象征性的，合法的，占主导地位的结构约束或使PSW在不同的组织环境中发挥作用？(2)PSW如何重新（创建）或抵制结构来支持有MH问题的服务用户？

Peer support workers (PSWs) are individuals with lived experience of mental health (MH) problems who are employed in a peer support capacity in public and voluntary sector MH settings. PSWs are a valuable part of the MH workforce (Department of Health, 2007). However, inflexibilities in highly standardised organisational environments can impose constraints on the PSW role limiting their ability to meaningfully impact MH systems (Gillard et al., 2014). This project will explore how the PSW role is implemented in two different MH settings with a particular focus on the relationship between PSW and organisational culture. Using structuration theory, I will explore how social structures (MH organisations, rules, resources) both constrain and shape individual agency (PSWs actions and behaviour), which in turn serve to (re)produce and shape structures. Through separating structure into three forms: Domination, Signification, and Legitimation, will allow for a better understanding of how PSWs negotiate complex mental health structural systems (Giddens, 1979). A comparative ethnographic case study approach will be employed to address the following two questions: (1) in what ways do the symbolic, legitimate, and dominant structures constrain or enable PSWs to carry out their role in different organisational settings? (2) How do PSWs re(create) or resist structures to support service users with MH problems?