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Opie JE, Vuong A, Maylea C, Khalil H, Brown L, Macafee A, Ah Ket B, Pearce N, Guerin N, McIntosh JE. Understanding Lived Experience Organizations: A Systematic Scoping Review of Organizational Elements and Characteristics. Psychiatr Serv 2024:appips20230643. [PMID: 39188148 DOI: 10.1176/appi.ps.20230643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
OBJECTIVE Mental health lived experience organizations (LEOs) and their lived experience workforce are increasingly recognized as invaluable. However, a deeper understanding of the elements that enhance or inhibit LEOs' efficacy is required to learn how to sustain LEOs and support their workforce. Rapid international expansion has resulted in significant LEO growth and change, challenging many LEOs to adapt. With this rapid expansion, the field is evolving faster than many LEOs can keep pace with. This review, codesigned and coproduced in partnership with a LEO to draw on both lived experience and academic perspectives, aims for a deeper understanding of which elements within a LEO enhance or inhibit its efficacy, growth, and support for its lived experience workforce. METHODS A systematic search of peer-reviewed and non-peer-reviewed literature, following the PRISMA-ScR guidelines and JBI methodology, identified 60 records published in English between 2000 and 2022. RESULTS The results indicate general agreement regarding which LEO elements are important (e.g., culture, leadership, board composition, organizational structure, financial arrangements, and professionalization). However, considerable disagreements exist regarding the relative influence of several of these elements, especially funding arrangements, in which funder and LEO values often diverge; training for increased lived experience professionalization; and partnerships with medical model-focused mental health services. CONCLUSIONS Organizational disagreements relate to managing future LEO growth and advancing the lived experience workforce while preserving LEOs' unique characteristics that make them valued mental health services. Further research should examine community differences among LEOs, including hybrid LEOs within services and non-LEO mental health organizations.
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Affiliation(s)
- Jessica E Opie
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - An Vuong
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Christopher Maylea
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Hanan Khalil
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Louis Brown
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Alexandra Macafee
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Blossom Ah Ket
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Natalie Pearce
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Nicola Guerin
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
| | - Jennifer E McIntosh
- Bouverie Centre (Opie, Vuong, McIntosh), School of Psychology and Public Health (Opie, Vuong, Khalil, McIntosh), and La Trobe Law School (Maylea), La Trobe University, Melbourne; School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown); Victorian Mental Illness Awareness Council, Melbourne (Macafee, Ah Ket, Guerin); Library, La Trobe University, Bendigo, Victoria, Australia (Pearce)
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Brown LD, Vasquez D, Wolf J, Robison J, Hartigan L, Hollman R. Supporting Peer Support Workers and Their Supervisors: Cluster-Randomized Trial Evaluating a Systems-Level Intervention. Psychiatr Serv 2024; 75:514-520. [PMID: 38204374 DOI: 10.1176/appi.ps.20230112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Peer support workers are a substantial and growing part of the mental health workforce. Because little research has investigated how to effectively support and supervise peer support workers, the authors evaluated the efficacy of a training program to strengthen the peer support workforce and the supervision of its workers. METHODS Mental health services sites with peer support workers and supervisors in Los Angeles County were recruited for this cluster-randomized trial and 10-month follow-up. Of 348 peer support workers and 143 supervisors at 85 sites, 251 (72%) peer support workers and 115 (80%) supervisors completed baseline surveys. SHARE! the Self-Help And Recovery Exchange, a peer-run organization, delivered four training sessions on strategies to reduce stigma and to build an effective peer workforce, cultural competence, and a trauma-informed developmental model of supervision. Primary outcomes were peer-supportive organizational climate, mental health stigma, and peer support worker recovery. RESULTS Intention-to-treat analyses indicated that sites receiving the training had significantly higher scores on peer-supportive organizational climate (Cohen's d=0.35, 95% CI=0.02-0.68, p=0.04) relative to sites not receiving the training. No significant differences were found between the two conditions for mental health stigma (Cohen's d=0.04) or peer support worker recovery (Cohen's d=0.14). CONCLUSIONS The training had no impact on mental health stigma or peer support worker recovery. However, the findings suggest that the training increased the value organizations gave to peer support work, which may help improve peer support worker retention and outcomes among those served. Efforts to incorporate principles of the training into practice may strengthen outcomes.
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Affiliation(s)
- Louis D Brown
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown, Vasquez); Decision Solutions, Stratford, Connecticut, and Department of Psychiatry, Yale School of Medicine, New Haven (Wolf); SHARE! the Self-Help And Recovery Exchange, Los Angeles (Robison, Hartigan, Hollman)
| | - Denise Vasquez
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown, Vasquez); Decision Solutions, Stratford, Connecticut, and Department of Psychiatry, Yale School of Medicine, New Haven (Wolf); SHARE! the Self-Help And Recovery Exchange, Los Angeles (Robison, Hartigan, Hollman)
| | - Jessica Wolf
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown, Vasquez); Decision Solutions, Stratford, Connecticut, and Department of Psychiatry, Yale School of Medicine, New Haven (Wolf); SHARE! the Self-Help And Recovery Exchange, Los Angeles (Robison, Hartigan, Hollman)
| | - Jason Robison
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown, Vasquez); Decision Solutions, Stratford, Connecticut, and Department of Psychiatry, Yale School of Medicine, New Haven (Wolf); SHARE! the Self-Help And Recovery Exchange, Los Angeles (Robison, Hartigan, Hollman)
| | - Libby Hartigan
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown, Vasquez); Decision Solutions, Stratford, Connecticut, and Department of Psychiatry, Yale School of Medicine, New Haven (Wolf); SHARE! the Self-Help And Recovery Exchange, Los Angeles (Robison, Hartigan, Hollman)
| | - Ruth Hollman
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston (Brown, Vasquez); Decision Solutions, Stratford, Connecticut, and Department of Psychiatry, Yale School of Medicine, New Haven (Wolf); SHARE! the Self-Help And Recovery Exchange, Los Angeles (Robison, Hartigan, Hollman)
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Stewart S, Scholz B, Gordon S, Happell B. 'It depends what you mean by leadership': An analysis of stakeholder perspectives on consumer leadership. Int J Ment Health Nurs 2019; 28:339-350. [PMID: 30281898 DOI: 10.1111/inm.12542] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2018] [Indexed: 01/06/2023]
Abstract
Contemporary mental health policies call for increased involvement of consumers in leadership across mental health service design, delivery, and evaluation. However, consumer leadership is not currently well understood within academia or in mental health services themselves. This study investigates how consumer leadership is currently conceptualized by stakeholders at the service delivery level. To this end, semistructured interviews were conducted with 14 mental health organization members identifying as consumer leaders, colleagues supporting consumer leaders, or organization executives. Interview data were analysed using an inductive thematic analysis to develop a broad understanding of participants' perceptions of consumer leadership. Findings indicate constructions of consumer leadership within mental health organizations can be understood in relation to four themes: consumer leadership roles, requirements, purpose, and process. Inconsistencies across participants' perceptions of consumer leadership were identified as constituting barriers to its development, highlighting the need to better clarify the nature of consumer leadership.
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Affiliation(s)
- Stephanie Stewart
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Brett Scholz
- ANU Medical School, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Brenda Happell
- School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
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Piat M, Sabetti J, Padgett D. Emergent leadership among tenants with psychiatric disabilities living in supported housing. Int J Ment Health Nurs 2018; 27:1127-1136. [PMID: 29277953 DOI: 10.1111/inm.12428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 11/29/2022]
Abstract
The overall aim of this study was to explore the experiences of people with psychiatric disabilities living as tenants in independent, supported apartments for the first time. Supported housing provides an alternative to structured, custodial housing models, such as foster homes, or board-and-care homes, for clients in public mental health systems. This article reports findings on how leadership emerged among tenants after making the transition from custodial to supported housing. Semi-structured interviews were conducted with tenants (n = 24) and included questions on their housing history, current living situation, relationships with staff, participation, and understanding or experience of leadership. Interviews were transcribed verbatim, codes generated, and a thematic analysis conducted using a constructivist approach. The findings revealed an understanding and appreciation of leadership among tenants, who identified six pathways to leadership in their housing as a response to unmet tenant needs. Most tenant leaders emerged outside of formal authority or power structures. Supported housing provides a unique social setting and empowering community where the potential of persons with psychiatric disabilities to assume leadership may be realized and further developed. Mental health professionals working in community housing networks are well placed to harness these face-to-face tenant communities, and their natural leaders, as an additional tool in promoting tenant recovery, mutual help, neighbourhood integration, and the broader exercise of citizenship.
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Affiliation(s)
- Myra Piat
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Judith Sabetti
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Deborah Padgett
- Silver School of Social Work, New York University, New York City, NY, USA
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Scholz B, Gordon S, Happell B. Consumers in mental health service leadership: A systematic review. Int J Ment Health Nurs 2017; 26:20-31. [PMID: 28093883 DOI: 10.1111/inm.12266] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2016] [Indexed: 11/29/2022]
Abstract
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services.
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Affiliation(s)
- Brett Scholz
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Brenda Happell
- SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Canberra, Australian Capital Territory, Australia
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