Davidson Larry, Chinman Matthew, Sells David, Rowe Michael
Program for Recovery and Community Health, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
Schizophr Bull. 2006 Jul;32(3):443-50. doi: 10.1093/schbul/sbj043. Epub 2006 Feb 3.
Peer support is based on the belief that people who have faced, endured, and overcome adversity can offer useful support, encouragement, hope, and perhaps mentorship to others facing similar situations. While this belief is well accepted for many conditions, such as addiction, trauma, or cancer, stigma and stereotypes about mental illness have impeded attempts on the part of people in recovery to offer such supports within the mental health system. Beginning in the early 1990s with programs that deployed people with mental illness to provide conventional services such as case management, opportunities for the provision and receipt of peer support within the mental health system have proliferated rapidly across the country as part of the emerging recovery movement. This article defines peer support as a form of mental health care and reviews data from 4 randomized controlled trials, which demonstrated few differences between the outcomes of conventional care when provided by peers versus non-peers. We then consider what, if any, unique contributions can be made by virtue of a person's history of serious mental illness and recovery and review beginning efforts to identify and evaluate these potential valued-added components of care. We conclude by suggesting that peer support is still early in its development as a form of mental health service provision and encourage further exploration and evaluation of this promising, if yet unproven, practice.
同伴支持基于这样一种信念,即那些经历过、承受过并战胜过逆境的人能够为面临类似情况的其他人提供有益的支持、鼓励、希望,或许还能给予指导。虽然这种信念在许多情况下都被广泛接受,比如成瘾、创伤或癌症,但对精神疾病的污名化和刻板印象阻碍了康复者在心理健康系统中提供此类支持的尝试。从20世纪90年代初开始,随着一些项目让患有精神疾病的人去提供诸如病例管理等常规服务,作为新兴康复运动的一部分,心理健康系统内提供和接受同伴支持的机会在全国迅速增多。本文将同伴支持定义为一种心理健康护理形式,并回顾了4项随机对照试验的数据,这些试验表明,由同伴提供的常规护理与非同伴提供的常规护理在结果上几乎没有差异。然后,我们思考凭借一个人严重精神疾病和康复的经历能做出哪些独特贡献(如果有的话),并回顾为识别和评估这些潜在的护理增值成分所做的初步努力。我们最后指出,同伴支持作为一种心理健康服务形式仍处于发展初期,并鼓励对这种有前景但尚未得到证实的做法进行进一步探索和评估。