Chinman Matthew, Young Alexander S, Hassell Joseph, Davidson Larry
Health Services Unit, West Los Angeles VA MIRECC, 11301 Wilshire Blvd., 210A, CA 90073, USA.
J Behav Health Serv Res. 2006 Apr;33(2):176-95. doi: 10.1007/s11414-006-9009-3.
Encouraged by the New Freedom Commission, mental health systems such as the Veteran Administration (VA) are now becoming more recovery-oriented. Consumer providers (CPs)--those with serious mental illness who are further along in recovery who provide services to others with similar mental health problems--are viewed as a key part of this change. However, organizational change theories suggest that careful consideration of implementation issues is critical when disseminating new and sometimes controversial services into existing organizations. Therefore, to guide the dissemination of CP services, the literature on the effectiveness of CPs was reviewed, and interviews, focus groups, and a brief survey of 110 administrators, providers, and patients were conducted at three large VA clinics in Southern California. Questions focused on their perceptions of feasibility and acceptability of CP services. Using literature and study findings, an organizational change framework and other strategies to overcome potential implementation challenges of CP services are suggested.
在新自由委员会的推动下，诸如退伍军人管理局（VA）之类的心理健康系统如今正变得更加以康复为导向。消费者提供者（CPs）——那些患有严重精神疾病但康复进程更为顺利并为其他有类似心理健康问题的人提供服务的人——被视为这一转变的关键部分。然而，组织变革理论表明，在将新的、有时存在争议的服务推广到现有组织时，仔细考虑实施问题至关重要。因此，为指导CP服务的推广，我们查阅了关于CP有效性的文献，并在南加州的三家大型VA诊所对110名管理人员、提供者和患者进行了访谈、焦点小组讨论以及一项简短调查。问题集中在他们对CP服务的可行性和可接受性的看法上。利用文献和研究结果，我们提出了一个组织变革框架以及其他策略，以克服CP服务潜在的实施挑战。
