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Ahlstrand A, Mishina K, Elomaa-Krapu M, Joronen K. Consumer involvement and guiding frameworks in mental healthcare: An integrative literature review. Int J Ment Health Nurs 2024. [PMID: 38706160 DOI: 10.1111/inm.13343] [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] [Received: 11/10/2023] [Revised: 03/26/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
Perspectives of healthcare have, in past decades, focused more on active citizenship, human rights and empowerment. Healthcare consumer involvement as a concept is still unstructured and consumers have no apparent opportunities to participate in their care processes. The focus is often on the expertise of professionals, even if mental health consumers are willing to become involved and have sufficient decisional capacity. The aim of this integrative literature review was to construct an understanding of consumer perceptions and guiding frameworks of consumer involvement. There was no previous synthesis of mental health consumer perceptions combined with guiding frameworks. An integrative review methodology was employed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the 18 studies included was analysed with the Whittemore and Knafl approach. By following Braun and Clarke's guidelines, an inductive thematic analysis was conducted to collate the themes from the selected papers. Mental health consumers' perceptions of involvement included expectations of person-centred care, such as respect, dignity, equal interaction, supportive environments and being part of a community. This research did not find any single established framework to give clear guidelines for consumer involvement in mental healthcare, but similar determinants describing various frameworks were uncovered. This review also shows how the terminology has changed throughout the years. The perceptions of mental health consumers need to be considered to enable the implementation of person-centredness from guidelines through to practice. Paying more attention to the education of professional mental health caregivers and the involvement of mental health consumers in their care provides better opportunities to co-develop successful mental health services and recovery processes.
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Affiliation(s)
- Anita Ahlstrand
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Minna Elomaa-Krapu
- Metropolia University of Applied Sciences, Helsinki, Finland
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
| | - Katja Joronen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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Viking T, Wenzer J, Hylin U, Nilsson L. Peer support workers’ role and expertise and interprofessional learning in mental health care: a scoping review. J Interprof Care 2022; 36:828-838. [PMID: 35129027 DOI: 10.1080/13561820.2021.2014796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- T. Viking
- University West, Trollhättan, Sweden
| | - J. Wenzer
- University of Gothenburg, Gothenburg, Sweden
| | - U. Hylin
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
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Mak WWS, Fu ACM, Auyeung L, Cheng WWL, Chan RCH, Tse SSK, Yau SSW, Ho K, Chan SK, Wong S. Nine-Month Longitudinal Impact of Peer Support Workers' Recovery Attributes on Service Users' Recovery in Hong Kong. Psychiatr Serv 2021; 72:1282-1287. [PMID: 34015963 DOI: 10.1176/appi.ps.202000006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, the authors investigated the longitudinal effect of the recovery attributes of peer support workers (PSWs) on users of mental health services in Hong Kong over a 9-month period. METHODS Recovery attributes were measured among PSWs (N=26) employed by four local nongovernmental organizations before their commencement of service. The recovery-related outcomes of regular service users (N=181) were measured every 3 months for 9 months. Multilevel mixed-effects linear regression analyses with restricted maximum likelihood were used to analyze the possible association of PSWs' qualities on service users' recovery outcomes. The Holm-Bonferroni method was used to adjust for p values to account for multiple comparisons. RESULTS Results showed that levels of hope and self-esteem among PSWs were statistically significantly associated with improvements in hope and empowerment among service users over time. CONCLUSIONS PSWs' recovery attributes may benefit service users' personal recovery. Future exploration on the specific pathways of recovery attributes of PSWs on service users' recovery is suggested.
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Affiliation(s)
- Winnie W S Mak
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Amanda C M Fu
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Larry Auyeung
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Winnie W L Cheng
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Randolph C H Chan
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Samson S K Tse
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Sania S W Yau
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Kimmy Ho
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Sau Kam Chan
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
| | - Stephen Wong
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong (Mak, Fu, Auyeung, Cheng); Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong (R. C. H. Chan); Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong (Tse); New Life Psychiatric Rehabilitation Association, Kowloon, Hong Kong (Yau); Mental Health Association of Hong Kong, Kwun Tong, Hong Kong (Ho); Baptist Oi Kwan Social Service, Wanchai, Hong Kong (S. K. Chan); Rehabilitation Service, Caritas Hong Kong, Tsuen Wan, Hong Kong (Wong)
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Stirrup V, Jones FW, Dimond I, Green D, Kaur J, Wattingham A, MacInnes D. Developing and evaluating mental health lived experience practitioner (LXP) roles in an NHS trust. J Ment Health 2021; 31:255-262. [PMID: 34569392 DOI: 10.1080/09638237.2021.1952956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The value of establishing roles for people with lived experience of mental distress within mental health services is increasingly being recognised. However, there is limited information to guide the introduction of these roles into mental health services. AIMS This study details the development and evaluation of a new mental health peer worker role, the Lived Experience Practitioner (LXP), within an NHS Trust. METHODS A three-phase exploratory mixed-methods approach was used. Qualitative data were collected and analysed in the first phase. The qualitative findings were then translated into the formal procedures for introducing LXPs into the Trust, with the approach examined quantitatively in the third phase. RESULTS The qualitative analysis identified five themes; role design, training, piloting, career pathways and communication. These formed the basis for working groups (workstreams) which developed policies and procedures for introducing the LXP role into the Trust. Twenty-eight applicants commenced a training programme with 10 successful completions. Seven LXPs were employed by the Trust and were still in their posts after 2 years. CONCLUSION In this study, three areas were viewed as important when introducing LXP roles into mental health services; organisational support, the training programme and employment procedures.
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Affiliation(s)
- Victoria Stirrup
- Faculty of Medicine Health and Social Care, Canterbury Christ Church University, Canterbury, UK
| | - Fergal W Jones
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Tunbridge Wells, UK
| | | | - Debbie Green
- Department of Allied Health Sciences, London South Bank University, London, UK
| | | | | | - Douglas MacInnes
- Faculty of Medicine Health and Social Care, Canterbury Christ Church University, Canterbury, UK
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5
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Byrne L, Roennfeldt H, Wolf J, Linfoot A, Foglesong D, Davidson L, Bellamy C. Effective Peer Employment Within Multidisciplinary Organizations: Model for Best Practice. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:283-297. [PMID: 34478040 DOI: 10.1007/s10488-021-01162-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 01/17/2023]
Abstract
This study sought a clearer understanding of organizational mechanisms reinforcing effective peer employment and organizational change from the perspectives of peer workers, non-peer staff and management in multidisciplinary mental health and substance use recovery services. Findings were used to develop a model for organizational best practice for peer employment and associated organizational change to promote recovery-oriented and person-directed services. Qualitative research was undertaken, involving 132 people participating in 14 focus groups and eight individual interviews. These people were employed across five U.S. multidisciplinary organizations providing mental health and substance use recovery services and deemed by a panel of experts to provide effective employment of peer workers. Study findings include the articulation of an interactive working model of best practice, comprising organizational commitment, organizational culture and effective organizational strategies necessary for a "whole-of-organization" approach to support authentic peer work and enable organizational transformation, to actualize recovery-oriented values and person-driven services. Strategies include Human Resources engagement, peers in positions of senior organizational authority, recurring whole of workforce training, along with peer training and peer-led supervision. Findings suggest whole-of-organization commitment, culture and practice are essential for the organizational transformation needed to support effective employment of peers in multidisciplinary environments.
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Affiliation(s)
- Louise Byrne
- School of Management, RMIT University, 124 La Trobe St, Melbourne, VIC, 3000, Australia. .,Department of Psychiatry, Program for Recovery and Community Health, Yale School of Medicine, Building. 1 Erector Square, 319 Peck Street, New Haven, CT, 06513, USA.
| | - Helena Roennfeldt
- School of Management, RMIT University, 124 La Trobe St, Melbourne, VIC, 3000, Australia
| | - Jessica Wolf
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA
| | - Ally Linfoot
- Clackamas County Behavioral Health Division, Peer Delivered Services System of Care, 2051 Kaen Road, Oregon City, OR, 97045, USA
| | - Dana Foglesong
- National Association of Peer Supporters, 712 H St NE PMB 65, Washington, DC, 20002, USA
| | - Larry Davidson
- Department of Psychiatry, Program for Recovery and Community Health, Yale School of Medicine, Building. 1 Erector Square, 319 Peck Street, New Haven, CT, 06513, USA
| | - Chyrell Bellamy
- Department of Psychiatry, Program for Recovery and Community Health, Yale School of Medicine, Building. 1 Erector Square, 319 Peck Street, New Haven, CT, 06513, USA
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Nguyen J, Goldsmith L, Rains LS, Gillard S. Peer support in early intervention in psychosis: a qualitative research study. J Ment Health 2021; 31:196-202. [PMID: 33961753 DOI: 10.1080/09638237.2021.1922647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is evidence that peer support can be helpful for people suffering from psychosis, but there is a lack of research describing peer support in the context of Early Intervention in Psychosis (EIP). AIMS We aim to investigate the key elements of peer support in EIP and how peer support workers might best be recruited and supported in their work. METHOD We used purposive sampling to recruit seven participants for semi-structured interviews. Thematic analysis was used to analyse the data. RESULTS Destigmatisation of psychotic experiences is a central concept that runs through all themes. Participants perceived peer support as a meaningful source of support that could provide benefits to peers (service users) and peer support workers. Themes included a "symbol of hope," "practical support," "mutuality and reciprocity," "bridge between service and peers," "ideal requirements of peer support workers," "delivering peer support," and "team-working and role clarification." CONCLUSIONS Peer support makes a strong contribution to destigmatising psychosis. Findings potentially contribute to developing peer support workers' roles in EIP. Future research is recommended to investigate the perspectives of ethnic minorities on this topic and practical applications of these findings.
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Affiliation(s)
- Jen Nguyen
- Department of Psychiatry, University College London, London, UK
| | - Lucy Goldsmith
- Population Health Research Institute, St George's, University of London, London, UK
| | - Luke Sheridan Rains
- NIHR Mental Health Policy Research Unit, University College London, London, UK
| | - Steve Gillard
- School of Health Sciences, City, University of London, London, UK
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Hegedüs A, Burr C, Pfluger V, Sieg D, Nienaber A, Schulz M. Peer support worker training: Results of the evaluation of the Experienced Involvement training programme in Switzerland and Germany. Int J Ment Health Nurs 2021; 30:451-460. [PMID: 33118298 DOI: 10.1111/inm.12805] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 01/26/2023]
Abstract
The 'Experienced Involvement' (EX-IN) training programme prepares and certifies individuals who have experienced mental health problems to work as peer support workers and to support others challenged by similar conditions. We aimed to assess the impact of the EX-IN training on hope, self-efficacy, introspection, stigma resistance, personal recovery, health-related quality of life and employment in participants. Data was collected using standardized assessment instruments before the training started (t1) and upon course completion (t2). Data from 103 participants who participated in both measurement times were included into data analysis. Participants significantly improved their recovery, stigma resistance and introspection during the EX-IN training. In addition, a significant higher proportion of participants were employed at t2. Participants whose last inpatient stay was 0-1 year before the start of the EX-IN training showed significantly lower levels of stigma resistance, and self-efficacy at t1 than participants with two or more years since the last inpatient stay. There were no significant changes in mean values over time, or in the mean values at t2 between the two groups. EX-IN training has a positive influence on the handling of stigma, on one's recovery path and introspection. This indicates that EX-IN training has a therapeutic effect on the participants. EX-IN training seems to meet the challenges of peer support work. Therefore, the training can be recommended as preparation for working as a peer support worker as well as an intervention to improve one´s recovery process.
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Affiliation(s)
- Anna Hegedüs
- Research Institute, Careum School of Health, Zurich, Switzerland.,International Graduate Academy (InGrA), "Participation as Goal of Nursing and Therapy", Institute of Health and Nursing Sciences, Martin-Luther-University Halle-Wittenberg, Halle-Wittenberg, Germany
| | - Christian Burr
- Departement of Clinical Nursing Science, University Psychiatric Services, Bern, Switzerland
| | - Viviane Pfluger
- Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Daniel Sieg
- Diaconia University of Applied Sciences, Bielefeld, Germany
| | - André Nienaber
- University of Applied Sciences Münster, Münster, Germany
| | - Michael Schulz
- LWL-Clinic Gütersloh, Gütersloh, Germany.,Institute of Health and Nursing Sciences, Martin-Luther-University Halle-Wittenberg, Halle-Wittenberg, Germany
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Evolvement of Peer Support Workers' Roles in Psychiatric Hospitals: A Longitudinal Qualitative Observation Study. Community Ment Health J 2021; 57:589-597. [PMID: 33367956 PMCID: PMC7904537 DOI: 10.1007/s10597-020-00741-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 10/31/2020] [Indexed: 01/15/2023]
Abstract
Peer support workers (PSWs) use their experiential knowledge and specific skills to support patients in their recovery process. The aim of our study was to examine the integration and role-finding process of PSWs in adult psychiatric hospitals in Germany. We conducted open nonparticipant observations of 25 multiprofessional team meetings and 5 transregional peer support worker meetings over a period of six months. The data were analyzed using qualitative content analysis. Regarding the integration of PSWs into multiprofessional teams, we identified three subcategories: "Features of success," "challenges" and "positioning between team and patients." Concerning the PSWs' roles, we developed two subcategories: "Offers" and "self-perception." The PSWs' specific roles within a multiprofessional mental healthcare team evolve in a process over a longer period of time. This role-finding process should be supported by a framework role description which leaves sufficient freedom for individual development. Regular opportunities for mutual exchange among PSWs can help to address specific support needs at different points in time.
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Wyder M, Roennfeldt H, Parker S, Vilic G, McCann K, Ehrlich C, Dark FL. Diary of a Mental Health Peer Worker: Findings From a Diary Study Into the Role of Peer Work in a Clinical Mental Health Setting. Front Psychiatry 2020; 11:587656. [PMID: 33391052 PMCID: PMC7773650 DOI: 10.3389/fpsyt.2020.587656] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/26/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: The importance of peer support workers in mental health care delivery has been extensively advocated for in mental health policy frameworks. However, there has been limited research examining the implementation of paid peer workers in clinical settings. This study explores the experience of paid peer support workers integrated within a clinically-operated community-based residential rehabilitation service for people diagnosed with a mental health disorder experiencing challenges living independently in the community. Methods: A general inductive approach was taken in the analysis of diaries completed by a newly employed peer workforce. These diaries focussed on what they viewed as significant interactions in fulfilling their role. Composite vignettes were generated to illustrate key themes. Findings: Thirty-six diaries were provided; these reported unplanned and spontaneously occurring interactions. Peer workers emphasized the importance of connecting with people while they were engaging in everyday activities as an opportunity for personal growth of the residents. The diaries also focussed on the peer workers' ability to connect and establish trust by sharing similar experiences with residents or family members. Peer workers also believed that they brought a different perspective than clinical staff and were able to refocus attention from clinical diagnoses and symptoms to other aspects of the resident's lives. Discussion: Peer support workers described their work as flexible, responsive, and adaptable to the resident's needs. They believed that their roles brought a different lens to interactions on the unit and fostered a more inclusive and personal way of working for the team. Conclusion: To ensure that peer workers can engage authentically with residents and family members, it is critical that the role and principles of peer work are valued and understood by all.
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Affiliation(s)
- Marianne Wyder
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
- The Hopkins Centre, Menzies Health Institute, Griffith University, Logan, QLD, Australia
| | - Helena Roennfeldt
- The Hopkins Centre, Menzies Health Institute, Griffith University, Logan, QLD, Australia
- The School of Business, RMIT University, Melbourne, VIC, Australia
| | - Stephen Parker
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
| | - Gabrielle Vilic
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
| | - Karen McCann
- Metro South Addiction and Mental Health Services, Brisbane, QLD, Australia
| | - Carolyn Ehrlich
- The Hopkins Centre, Menzies Health Institute, Griffith University, Logan, QLD, Australia
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Scanlan JN, Still M, Radican J, Henkel D, Heffernan T, Farrugia P, Isbester J, English J. Workplace experiences of mental health consumer peer workers in New South Wales, Australia: a survey study exploring job satisfaction, burnout and turnover intention. BMC Psychiatry 2020; 20:270. [PMID: 32487169 PMCID: PMC7268613 DOI: 10.1186/s12888-020-02688-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 05/20/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Consumer peer workers are individuals with lived experience of mental health issues and recovery who are employed to use their lived experience to support others. The consumer peer workforce has expanded substantially in recent years. While some research has explored the workplace experiences of peer workers, no previous studies have explored job satisfaction, burnout or turnover intention for this workforce. METHODS Consumer peer workers in New South Wales, Australia were invited to complete a survey designed to explore their workplace experiences. The survey included measures of job satisfaction, burnout, turnover intention, job demands and job resources, and satisfaction with supervision, professional development and opportunities for career progression. Questions also explored positive and negative aspects of positions. Analyses included exploration of the relationships between of job satisfaction, burnout, turnover intention, job demands and job resources as well as tabulation of common positive and negative aspects of positions. Results were also compared with findings from a previous study exploring workplace experiences of other mental health workers. RESULTS A total of 67 peer workers participated in the study. Overall job satisfaction, burnout (disengagement and exhaustion) and turnover intention for peer workers was not significantly different to other mental health workers. Job satisfaction, disengagement, exhaustion and turnover intention were all significantly inter-related. Job resources of social support, job control, feedback, and rewards and recognition were associated with positive workplace experiences and the job demand of "physical environment" was most substantially associated with poorer workplace experiences. The most common positive aspect of positions was "connecting with consumers" and the most common negative aspect of positions was "attitudes of clinicians / workplace culture". Access to supervision from a senior peer worker was associated with more positive workplace experiences. CONCLUSIONS This research demonstrates that while consumer peer workers do not appear to experience poorer job satisfaction or higher levels of burnout or turnover intention than other mental health workers, a range of challenges do exist. Efforts to further expand the peer workforce (especially senior peer worker roles) and to promote more positive attitudes and workplace cultures are likely to promote better workplace experiences for peer workers.
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Affiliation(s)
- Justin Newton Scanlan
- Present Affiliation: Faculty of Medicine and Health, The University of Sydney, Sydney School of Health Sciences, Office J120, Cumberland Campus, 75 East Street, Lidcombe, Sydney, NSW, 2141, Australia. .,Present Affiliation: Mental Health Services, Sydney Local Health District, Concord, NSW, Australia.
| | - Megan Still
- Present Affiliation: Mental Health Services, Sydney Local Health District, Concord, NSW Australia
| | - Jae Radican
- Present Affiliation: Official Visitors Program, Gladesville, NSW Australia ,Previous affiliation (at the time of the study): NSW Ministry of Health, Mental Health Branch, North Sydney, NSW Australia
| | - Daya Henkel
- Present Affiliation: NSW Ministry of Health, Mental Health Branch, Chatswood, NSW Australia ,Previous affiliation (at the time of the study): Hunter New England Local Health District, Mental Health Services, Newcastle, NSW Australia
| | - Tim Heffernan
- Present Affiliation: COORDINARE – South Eastern NSW Primary Health Network, Wollongong, NSW Australia
| | - Peter Farrugia
- Present Affiliation: Flourish Australia, Sydney Olympic Park, NSW Australia
| | - Jemima Isbester
- Present Affiliation: Mental Health Services, Sydney Local Health District, Concord, NSW Australia
| | - Jessica English
- Present Affiliation: ReachOut Australia, Sydney, Australia ,Previous affiliation (at the time of the study): Being: Mental Health and Wellbeing Consumer Advisory Group, Sydney, NSW Australia
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11
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Peck CE, Lim MH, Purkiss M, Foley F, Hopkins L, Thomas N. Development of a Lived Experience-Based Digital Resource for a Digitally-Assisted Peer Support Program for Young People Experiencing Psychosis. Front Psychiatry 2020; 11:635. [PMID: 32714223 PMCID: PMC7343891 DOI: 10.3389/fpsyt.2020.00635] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 06/18/2020] [Indexed: 12/11/2022] Open
Abstract
This paper describes the creation of a web-based digital resource designed for tablet computer use during peer work sessions to structure discussion about recovery in early psychosis. The resource consisted of a series of videos featuring young people who have used early psychosis services discussing how they navigated issues in their own recovery. A participatory process was used to create the resource. Researchers held a series of collaborative development workshops with early psychosis service users, peer workers, other mental health practitioners, and academics. These were used to derive a framework of recovery processes relevant to young people experiencing psychosis, which was considered as useful areas of discussion within a peer work relationship. A semi-structured interview guide based on this framework was then used in video-recorded interviews with young people in recovery from psychosis. Footage was edited into 14 videos and organized into six final themes: My Journey, Self-Care, Connections, My Identity, Life, and Mental Health. The combined expertise of young mental health service users, peer support workers, mental health practitioners, and digital mental health researchers throughout the development process enabled the creation of tailored digital resource for peer work in an early psychosis service.
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Affiliation(s)
- Claire E Peck
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Michelle H Lim
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.,Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Melanie Purkiss
- Headspace Youth Early Psychosis Program, Alfred Health, Melbourne, VIC, Australia
| | - Fiona Foley
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Liza Hopkins
- Headspace Youth Early Psychosis Program, Alfred Health, Melbourne, VIC, Australia
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.,Alfred Mental and Addiction Health, Alfred Hospital, Melbourne, VIC, Australia
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12
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Richardson LJ, Molyneaux V, Murray CD. Being a peer support mentor for individuals who have had a lower limb amputation: an interpretative phenomenological analysis. Disabil Rehabil 2019; 42:3850-3857. [DOI: 10.1080/09638288.2019.1611954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Craig D. Murray
- Faculty of Health & Medicine, Lancaster University, Lancaster, UK
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13
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Debyser B, Berben K, Beeckman D, Deproost E, Van Hecke A, Verhaeghe S. The transition from patient to mental health peer worker: A grounded theory approach. Int J Ment Health Nurs 2019; 28:560-571. [PMID: 30575270 DOI: 10.1111/inm.12561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2018] [Indexed: 11/28/2022]
Abstract
Peer workers are increasingly being engaged in contemporary mental healthcare. To become a peer worker, patients must evolve from having a patient identity to a peer worker identity. This study aims to understand how mental health peer workers experience their transition and how it affects their view of themselves and their direct working context. A grounded theory approach was used. Seventeen mental health peer workers in Belgium were recruited through theoretical sampling. Semi-structured interviews were conducted and analysed according to the constant comparative method. The results indicate that novice peer workers experience peer work as an opportunity to liberate themselves from the process of mental suffering and realise an acceptable form of personal self-maintenance. As peer workers become more experienced, they are confronted with external factors that influence their self-maintenance and personal development. Experiencing clarity in their duties and responsibilities, equality, and transparency in the workplace reinforce their experience of self-maintenance and positively influence their self-development. Experiencing a lack of clarity in their duties and responsibilities, inequality, and lack of openness discourage peer workers' self-development process. These experiences challenge their personal motivations to become peer workers, which are usually linked to building a meaningful life for themselves. The insights can encourage organisations to build up a supportive environment collaboratively with peer workers and ensure that peer workers can exert their authentically unique role in mental healthcare.
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Affiliation(s)
- Bart Debyser
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,VIVES University of Applied Sciences, Kortrijk, Belgium.,Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Kevin Berben
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Alexian Psychiatric Hospital, Tienen, Alexianen Care Group, Tienen, Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Sweden.,School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eddy Deproost
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,VIVES University of Applied Sciences, Kortrijk, Belgium.,Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Staff member Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,VIVES University of Applied Sciences, Kortrijk, Belgium
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14
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Burke EM, Pyle M, Machin K, Morrison AP. Providing mental health peer support 1: A Delphi study to develop consensus on the essential components, costs, benefits, barriers and facilitators. Int J Soc Psychiatry 2018. [DOI: 10.1177/0020764018810299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Eilish M Burke
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Melissa Pyle
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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15
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Burke EM, Pyle M, Machin K, Morrison AP. Providing mental health peer support 2: Relationships with empowerment, hope, recovery, quality of life and internalised stigma. Int J Soc Psychiatry 2018; 64:745-755. [PMID: 30417721 DOI: 10.1177/0020764018810307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Qualitative research has identified personal costs and benefits for peer supporters associated with their role; however, quantitative evidence is sparse. This study used quantitative methods to explore relationships in experiences of providing peer support with constructs of empowerment, hope, recovery, quality of life and internalised stigma. Differences were examined for those in statutory versus non-statutory services; who had themselves received peer support versus those who had not and who identified having had negative experiences in clinical teams versus those without such experiences. METHODS A cross-sectional online and postal survey was undertaken in tandem with a linked consensus study. In all, 147 peer supporters were recruited from a variety of organisations across the United Kingdom. Validated questionnaires were used to examine constructs. Instruments created for the study measured peer support experiences, and personal costs and benefits involved. Correlations were calculated and results informed further regression analysis. Chi-square tests and independent samples t-tests tested group differences. RESULTS Peer supporters indicated they experienced almost twice as many role-related personal benefits than personal costs. Benefits included improvements to mental health and well-being, reduced use of services, increased social functioning and development of skills. Total number of personal costs experienced was significantly negatively related to peer supporters' empowerment and quality of life. There were no significant differences between the groups examined. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE An accumulation of personal costs may result in reduced quality of life; however, costs can be minimised by organisations. Limitations of the research are discussed and recommendations for future research are made including the need for longitudinal research.
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Affiliation(s)
- Eilish M Burke
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Melissa Pyle
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Anthony P Morrison
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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16
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Tookey P, Mason K, Broad J, Behm M, Bondy L, Powis J. From client to co-worker: a case study of the transition to peer work within a multi-disciplinary hepatitis c treatment team in Toronto, Canada. Harm Reduct J 2018; 15:41. [PMID: 30107808 PMCID: PMC6092784 DOI: 10.1186/s12954-018-0245-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/27/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Despite the integration of peer workers into harm reduction services, there is little documentation regarding the experience of this integration or of models in which peers are fully integrated as members of health care teams. The purpose of this study was to gain an in-depth understanding of the transition from client to support worker from the perspective of two individuals who received treatment for hepatitis C at a multi-disciplinary, community-based program, grounded in a harm reduction approach to substance use. METHODS A participatory case study design was selected. Interviews were conducted with two current peer workers who were also involved in the study design, analysis and writing. Data was coded and analyzed using an inductive approach to identify emergent themes. RESULTS Five primary themes emerged during our analysis of the facilitators and challenges of the transition from client to support worker: (1) the role of prior experience, (2) changes in substance use practices, (3) shifts in relationships with community members and friends, (4) supportive organizational and structural factors, and (5) role transition as a journey. In some cases, themes overlapped and contained elements that were both facilitating and challenging. CONCLUSIONS The transition from client to co-worker is a gradual process and one that is supported by, and in turn helps to support, a number of other personal transitions. The cases examined here suggest that a model of peer employment with broad qualification criteria, sufficient transition timelines, flexible job responsibilities, a solid investment in the inclusion of people with lived experience, and a harm reduction framework will support successful integration of current and/or former clients into health care teams.
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Affiliation(s)
- Paula Tookey
- South Riverdale Community Health Centre, 955 Queen St East, Toronto, ON M4M 3P3 Canada
| | - Kate Mason
- South Riverdale Community Health Centre, 955 Queen St East, Toronto, ON M4M 3P3 Canada
| | - Jennifer Broad
- South Riverdale Community Health Centre, 955 Queen St East, Toronto, ON M4M 3P3 Canada
| | - Marty Behm
- South Riverdale Community Health Centre, 955 Queen St East, Toronto, ON M4M 3P3 Canada
| | - Lise Bondy
- Department of Medicine, Division of Infectious Diseases, Schulich School of Medicine and Dentistry, Western University. St. Joseph’s Health Care, 268 Grosvenor Street, London, ON N6A 4V2 Canada
| | - Jeff Powis
- Michael Garron Hospital, 835 Coxwell Ave, Toronto, ON M4C 3E7 Canada
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17
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Moran GS. A recovery-oriented peer provider (ROPP) work-role model and prototype measure. AMERICAN JOURNAL OF PSYCHIATRIC REHABILITATION 2018. [DOI: 10.1080/15487768.2017.1374895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Galia S. Moran
- Department of Social Work, Ben-Gurion University, Beer Sheva, Israel
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18
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Debyser B, Duprez V, Beeckman D, Vandewalle J, Van Hecke A, Deproost E, Verhaeghe S. Mental health nurses and mental health peer workers: Self-perceptions of role-related clinical competences. Int J Ment Health Nurs 2018; 27:987-1001. [PMID: 29194905 DOI: 10.1111/inm.12406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 11/27/2022]
Abstract
In a mental healthcare that embraces a recovery-oriented practice, the employment of mental health peer workers is encouraged. Although peer workers are increasingly working together with nurses, there is a lack of research that explores how nurses and peer workers perceive their role-related competences in clinical practice. The aim of this study was to clarify and understand these self-perceptions in order to identify the specificity and potential complementarity of both roles. This insight is needed to underpin a successful partnership between both vocations. A qualitative descriptive research design based on principles of critical incident methodology was used. Twelve nurses and eight peer workers from different mental healthcare organizations participated. A total of 132 reported cases were analysed. Rigour was achieved through thick description, audit trail, investigator triangulation and peer review. Nurses relate their role-related competences predominantly with being compliant with instructions, being a team player and ensuring security and control. Peer workers relate their role-related competences with being able to maintain themselves as a peer worker, building up a relationship that is supportive for both the patient and themselves, and to utilize their lived experience. Both nurses and peer workers assign a major role to the team in determining their satisfaction with their competences. Consequently, what is perceived as important for the team appears to overshadow their self-assessment of competences. The findings highlighted the importance of paying more attention to identity construction, empowerment and role competence development of nurses and peer workers in their respective education and ongoing training.
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Affiliation(s)
- Bart Debyser
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium
| | - Veerle Duprez
- Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Joeri Vandewalle
- Department of Public Health, Ghent University, Ghent, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium
| | - Ann Van Hecke
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Eddy Deproost
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium
| | - Sofie Verhaeghe
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium
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19
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Pyle M, Pilling S, Machin K, Allende-Cullen G, Morrison AP. Peer support for internalised stigma experienced by people with psychosis: rationale and recommendations. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2018. [DOI: 10.1080/17522439.2018.1437212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Melissa Pyle
- The Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation , Manchester, UK
- Department of Psychology, The University of Manchester , Manchester, UK
| | - Stephen Pilling
- The Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation , Manchester, UK
| | - Karen Machin
- Institute of Mental Health, Education Team, University of Nottingham Innovation Park , Nottingham, UK
| | - Ginny Allende-Cullen
- The Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation , Manchester, UK
| | - Anthony P. Morrison
- The Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation , Manchester, UK
- Department of Psychology, The University of Manchester , Manchester, UK
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20
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Abstract
SummaryPeer worker roles are being introduced in mental health services in the UK and internationally, to support individuals in their recovery. There is substantial qualitative evidence that demonstrates benefits at an individual level and some evidence of impact on service use and costs, although there are currently few high-quality randomised controlled trials supporting these findings, especially from the UK. A growing body of research indicates that careful consideration of organisational issues regarding the introduction of peer worker roles – the distinctiveness and shared expectations of the role, strategic alignment, organisational support – might maximise their impact. Properly supported and valued peer workers are an important resource to the multidisciplinary team, offering experiential knowledge and the ability to engage patients in their treatment through building relationships of trust based on shared lived experience.LEARNING OBJECTIVESAppreciate the origins of the peer worker role and how the role has been introduced into mental health services to date.Understand the evidence for the benefits of peer worker roles, for patients, peer workers and mental health service delivery.Demonstrate awareness of the organisational and team-level barriers to and facilitators of introducing peer workers into, or alongside, existing multidisciplinary mental health teams.
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21
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Darwin Z, Green J, McLeish J, Willmot H, Spiby H. Evaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:466-477. [PMID: 26918879 DOI: 10.1111/hsc.12331] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 06/05/2023]
Abstract
Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of an independent multi-site evaluation of a volunteer doula service, this study examined women's experiences of one-to-one support from a trained volunteer doula during pregnancy, labour and the post-natal period among women living in five low-income communities in England. A mixed methods multi-site evaluation was conducted with women (total n = 137) who received the service before December 2012, using a combination of questionnaires (n = 136), and individual or group interviews (n = 12). Topics explored with women included the timing and nature of support, its impact, the relationship with the doula and negative experiences. Most women valued volunteer support, describing positive impacts for emotional health and well-being, and their relationships with their partners. Such impacts did not depend upon the volunteer's presence during labour and birth. Indeed, only half (75/137; 54.7%) had a doula attend their birth. Many experienced volunteer support as a friendship, distinct from the relationships offered by healthcare professionals and family. This led to potential feelings of loss in these often isolated women when the relationship ended. Volunteer doula support that supplements routine maternity services is potentially beneficial for disadvantaged women in the UK even when it does not involve birth support. However, the distress experienced by some women at the conclusion of their relationship with their volunteer doula may compromise the service's impact. Greater consideration is needed for managing the ending of a one-to-one relationship with a volunteer, particularly given the likelihood of it coinciding with a period of heightened emotional vulnerability.
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Affiliation(s)
- Zoe Darwin
- School of Healthcare, University of Leeds, Leeds, UK
| | | | - Jenny McLeish
- National Perinatal Epidemiological Unit, University of Oxford, Oxford, UK
| | - Helen Willmot
- Department of Health Sciences, University of York, York, UK
| | - Helen Spiby
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- School of Nursing and Midwifery, University of Queensland, Queensland, Australia
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22
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Spiby H, Mcleish J, Green J, Darwin Z. 'The greatest feeling you get, knowing you have made a big difference': survey findings on the motivation and experiences of trained volunteer doulas in England. BMC Pregnancy Childbirth 2016; 16:289. [PMID: 27680500 PMCID: PMC5041283 DOI: 10.1186/s12884-016-1086-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 09/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Support from a doula is known to have physical and emotional benefits for mothers, but there is little evidence about the experiences of volunteer doulas. This research aimed to understand the motivation and experiences of volunteer doulas who have been trained to support women during pregnancy, birth and the postnatal period. METHODS A postal questionnaire survey was sent to volunteer doulas at five volunteer doula projects working in low-income areas in England. Quantitative and qualitative data were analysed in parallel using summary statistics and content analysis respectively. RESULTS Eighty-nine volunteer doulas (response rate 34.5 %) from diverse backgrounds responded to the survey. Major motivators for volunteering included a desire to help others and, to a lesser extent, factors related to future employment. Most reported that the training was effective preparation for their role. They continued volunteering because they derived satisfaction from the doula role, and valued its social aspects. Their confidence, skills, employability and social connectedness had all increased, but many found the ending of the doula-mother relationship challenging. For a minority, negative aspects of their experience included time waiting to be allocated women to support and dissatisfaction with the way the doula service was run. DISCUSSION AND CONCLUSIONS Most respondents found the experience rewarding. To maintain doulas' motivation as volunteers, services should: ensure doulas can start supporting women as soon as possible after completing the training; consider the merits of more flexible endings to the support relationship; offer opportunities for ongoing mutual support with other doulas, and ensure active support from service staff for volunteers.
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Affiliation(s)
- Helen Spiby
- Division of Midwifery, Faculty of Medicine and Health Sciences, University of Nottingham, 12th Floor, Tower Building, Nottingham, NG7 2RD UK
| | - Jenny Mcleish
- Policy Research Unit for Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, OX3 7LF UK
| | - Josephine Green
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD UK
| | - Zoe Darwin
- Midwifery, Social Work and Counselling & Psychotherapy, School of Healthcare, University of Leeds, Leeds, LS2 9JT UK
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23
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Collins R, Firth L, Shakespeare T. "Very much evolving": a qualitative study of the views of psychiatrists about peer support workers. J Ment Health 2016; 25:278-83. [PMID: 27068009 DOI: 10.3109/09638237.2016.1167858] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mental health services continue to develop service user involvement, including a growth in employment of peer support workers (PSWs). Despite the importance of the views and attitudes expressed by psychiatrists, this topic has not previously been studied. AIMS To gain insight into the views and attitudes psychiatrists have about PSWs. METHODS A qualitative study based on semi-structured interviews with 11 psychiatrists in the East of England. RESULTS Psychiatrists were broadly positive and supportive of PSWs. Interviewees not only could anticipate a range of possible benefits of employing PSWs, but also had concerns regarding their implementation and management. There was a lack of clarity and consistency between interviewees about what the exact role of a PSW might involve. CONCLUSION This study provides insights into how PSWs are perceived by psychiatrists. While broadly positive attitudes exist, the research highlights certain challenges, particularly role ambiguity.
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Affiliation(s)
- Rachael Collins
- a Faculty of Medicine and Health Sciences , Norwich Medical School, University of East Anglia , Norwich , UK and
| | - Lucy Firth
- b Woodlands House, Norwich Community Hospital , Norwich , Norfolk , UK
| | - Tom Shakespeare
- a Faculty of Medicine and Health Sciences , Norwich Medical School, University of East Anglia , Norwich , UK and
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24
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Rodgers M, Thomas S, Harden M, Parker G, Street A, Eastwood A. Developing a methodological framework for organisational case studies: a rapid review and consensus development process. HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundOrganisational case study proposals can be poorly articulated and methodologically weak, raising the possible need for publication standards in this area.ObjectivesTo develop reporting standards for organisational case study research, with particular application to the UK National Health Service.DesignRapid evidence synthesis and Delphi consensus process.Data sourcesRelevant case studies and methods texts were identified through searches of library catalogues, key text and author searches, focused searching of health and social science databases and some targeted website searching.Review methodsThe reporting standards were developed in three stages: (1) a rapid review of the existing literature to identify items; (2) a modified Delphi consensus process to develop and refine content and structure; and (3) application of the high-consensus Delphi items to two samples of organisational case studies to assess their feasibility as reporting standards. Items for the Delphi consultation were identified from published organisational case studies and related methodological texts. Identified items were sent to a Delphi expert panel for rating over two rounds. Participants were also asked whether or not the provisional framework in which items were presented was appropriate, and were given the opportunity to adapt this alongside the content. In both rounds, the high-consensus threshold was set at 70% agreement among respondents for each item. High-consensus items from the Delphi consultation were then applied to previously identified case study publications to determine their relevance to the reporting of real-world organisational case studies and to better understand how the results of the Delphi consultation might best be implemented as a reporting standard.ResultsOne hundred and three unique reporting items were identified from 25 methodological texts; eight example case studies and 12 exemplar case studies did not provide any additional unique items. Thirteen items were ultimately rated as ‘Should be reported for all organisational case studies’ by at least 70% of respondents, with the degree of consensus ranging from 73% to 100%. As a whole, exemplar case studies [which had been provided by the National Institute for Health Research (NIHR)’s Health Services and Delivery Research (HSDR) programme as examples of methodologically strong projects] more consistently reported the high-consensus Delphi items than did case studies drawn from the literature more broadly.LimitationsTime and resource constraints prevented an initial ‘item-generation’ round in the Delphi consensus process. Items are therefore likely to have been influenced by the content, wording and assumptions of available literature.ConclusionsThe high-consensus items were translated into a set of 13 reporting standards that aim to improve the consistency, rigour and reporting of organisational case study research, thereby making it more accessible and useful to different audiences. The reporting standards themselves are intended primarily as a tool for authors of organisational case studies. They briefly outline broad requirements for rigorous and consistent reporting without constraining methodological freedom.Future workThese reporting standards should be included as part of the submission requirements for all organisational case studies seeking funding. Though these reporting standards do not mandate specific methods, if a reporting item is not reported for legitimate methodological reasons, the onus is on the author to outline their rationale for the reader.FundingThe NIHR HSDR programme.
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Affiliation(s)
- Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sian Thomas
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Melissa Harden
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Gillian Parker
- Social Policy Research Unit, University of York, York, UK
| | - Andrew Street
- Centre for Health Economics, University of York, York, UK
| | - Alison Eastwood
- Centre for Reviews and Dissemination, University of York, York, UK
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25
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Developing a change model for peer worker interventions in mental health services: a qualitative research study. Epidemiol Psychiatr Sci 2015; 24:435-45. [PMID: 24992284 PMCID: PMC8367355 DOI: 10.1017/s2045796014000407] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS A range of peer worker roles are being introduced into mental health services internationally. There is some evidence that attests to the benefits of peer workers for the people they support but formal trial evidence in inconclusive, in part because the change model underpinning peer support-based interventions is underdeveloped. Complex intervention evaluation guidance suggests that understandings of how an intervention is associated with change in outcomes should be modelled, theoretically and empirically, before the intervention can be robustly evaluated. This paper aims to model the change mechanisms underlying peer worker interventions. METHODS In a qualitative, comparative case study of ten peer worker initiatives in statutory and voluntary sector mental health services in England in-depth interviews were carried out with 71 peer workers, service users, staff and managers, exploring their experiences of peer working. Using a Grounded Theory approach we identified core processes within the peer worker role that were productive of change for service users supported by peer workers. RESULTS Key change mechanisms were: (i) building trusting relationships based on shared lived experience; (ii) role-modelling individual recovery and living well with mental health problems; (iii) engaging service users with mental health services and the community. Mechanisms could be further explained by theoretical literature on role-modelling and relationship in mental health services. We were able to model process and downstream outcomes potentially associated with peer worker interventions. CONCLUSIONS An empirically and theoretically grounded change model can be articulated that usefully informs the development, evaluation and planning of peer worker interventions.
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26
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Holley J, Gillard S, Gibson S. Peer worker roles and risk in mental health services: a qualitative comparative case study. Community Ment Health J 2015; 51:477-90. [PMID: 25690153 DOI: 10.1007/s10597-015-9843-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/09/2015] [Indexed: 11/24/2022]
Abstract
New peer worker roles are being introduced into mental health services internationally. This paper addresses a lack of research exploring issues of risk in relation to the role. In-depth interviews were carried out with 91 peer workers, service users, staff and managers. A grounded analysis revealed protective practice in minimising risk to peer worker well-being that restricted the sharing of lived experience, and a lack of insight into how peer workers might be involved in formal risk management. Alternatively, analysis revealed potential new understandings of risk management based on the distinctive, experiential knowledge that peer workers brought to the role.
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Affiliation(s)
- Jessica Holley
- Division of Population Health Sciences and Education, Section of Mental Health, St George's University of London, Cranmer Terrace, Tooting, Wandsworth, London, SW17 0RE, UK,
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A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons. BMC Public Health 2015; 15:290. [PMID: 25880001 PMCID: PMC4404270 DOI: 10.1186/s12889-015-1584-x] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 02/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prisoners experience significantly worse health than the general population. This review examines the effectiveness and cost-effectiveness of peer interventions in prison settings. METHODS A mixed methods systematic review of effectiveness and cost-effectiveness studies, including qualitative and quantitative synthesis was conducted. In addition to grey literature identified and searches of websites, nineteen electronic databases were searched from 1985 to 2012. Study selection criteria were: POPULATION Prisoners resident in adult prisons and children resident in Young Offender Institutions (YOIs). INTERVENTION Peer-based interventions. COMPARATORS Review questions 3 and 4 compared peer and professionally led approaches. OUTCOMES Prisoner health or determinants of health; organisational/process outcomes; views of prison populations. STUDY DESIGNS Quantitative, qualitative and mixed method evaluations. RESULTS Fifty-seven studies were included in the effectiveness review and one study in the cost-effectiveness review; most were of poor methodological quality. Evidence suggested that peer education interventions are effective at reducing risky behaviours, and that peer support services are acceptable within the prison environment and have a positive effect on recipients, practically or emotionally. Consistent evidence from many, predominantly qualitative, studies, suggested that being a peer deliverer was associated with positive effects. There was little evidence on cost-effectiveness of peer-based interventions. CONCLUSIONS There is consistent evidence from a large number of studies that being a peer worker is associated with positive health; peer support services are also an acceptable source of help within the prison environment and can have a positive effect on recipients. Research into cost-effectiveness is sparse. SYSTEMATIC REVIEW REGISTRATION PROSPERO ref: CRD42012002349.
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