Cabral Linda, Strother Heather, Muhr Kathy, Sefton Laura, Savageau Judith
Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, Massachusetts, USA.
Health Soc Care Community. 2014 Jan;22(1):104-12. doi: 10.1111/hsc.12072. Epub 2013 Oct 30.
Mental health peer specialists develop peer-to-peer relationships of trust with clients to improve their health and well-being, functioning in ways similar to community health workers. Although the number of peer specialists in use has been increasing, their role in care teams is less defined than that of the community health worker. This qualitative study explored how the peer specialist role is defined across different stakeholder groups, the expectations for this role and how the peer specialist is utilised and integrated across different types of mental health services. Data were collected through interviews and focus groups conducted in Massachusetts with peer specialists (N = 44), their supervisors (N = 14) and clients (N = 10) between September 2009 and January 2011. A consensus coding approach was used and all data outputs were reviewed by the entire team to identify themes. Peer specialists reported that their most important role is to develop relationships with clients and that having lived mental health experience is a key element in creating that bond. They also indicated that educating staff about the recovery model and peer role is another important function. However, they often felt a lack of clarity about their role within their organisation and care team. Supervisors valued the unique experience that peer specialists bring to an organisation. However, without a defined set of expectations for this role, they struggled with training, guiding and evaluating their peer specialist staff. Clients reported that the shared lived experience is important for the relationship and that working with a peer specialist has improved their mental health. With increasing support for person-centred integrated healthcare delivery models, the demand for mental health peer specialist services will probably increase. Therefore, clearer role definition, as well as workforce development focused on team orientation, is necessary for peer specialists to be fully integrated and supported in care teams.
心理健康同伴专家与客户建立起相互信任的同伴关系，以改善他们的健康和福祉，其工作方式类似于社区卫生工作者。尽管目前使用的同伴专家数量一直在增加，但他们在护理团队中的角色界定不如社区卫生工作者明确。这项定性研究探讨了不同利益相关者群体如何界定同伴专家的角色、对该角色的期望，以及同伴专家如何在不同类型的心理健康服务中得到利用和整合。2009年9月至2011年1月期间，在马萨诸塞州通过对同伴专家（N = 44）、他们的主管（N = 14）和客户（N = 10）进行访谈和焦点小组讨论收集了数据。采用了共识编码方法，所有数据输出均由整个团队进行审查以确定主题。同伴专家报告说，他们最重要的角色是与客户建立关系，而有过心理健康经历是建立这种联系的关键因素。他们还指出，向工作人员传授康复模式和同伴角色也是另一项重要职能。然而，他们常常觉得自己在组织和护理团队中的角色不够清晰。主管们重视同伴专家给组织带来的独特经验。然而，由于没有对该角色设定明确的期望，他们在培训、指导和评估同伴专家员工方面面临困难。客户报告说，共同的生活经历对这种关系很重要，与同伴专家合作改善了他们的心理健康。随着对以患者为中心的综合医疗服务模式的支持不断增加，对心理健康同伴专家服务的需求可能会上升。因此，对于同伴专家要在护理团队中得到充分整合和支持而言，更清晰的角色定义以及以团队为导向的劳动力发展是必要的。
