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在心理健康服务与社区之间的界面重视以康复为导向的实践:组织特征和环境的作用。

Valuing recovery-oriented practice at the interface between mental health services and communities: The role of organisational characteristics and environments.

机构信息

Personal Social Services Research Unit, The London School of Economics and Political Science, London, UK.

出版信息

Int J Soc Psychiatry. 2019 Mar;65(2):136-143. doi: 10.1177/0020764019831319. Epub 2019 Feb 26.

Abstract

BACKGROUND

Implementing recovery-oriented mental health services is a policy priority in many countries. In addition, some governments have prioritised new forms of organising, financing and governing the provision of mental health services with a stronger focus on co-delivery and involving communities. Most research in the recovery field has focused on interventions. There is limited knowledge about the role of organisational characteristics and environments in which people experience recovery.

AIM

To understand the organisational characteristics of initiatives that implement recovery-oriented practice at the interface between mental health services and communities, as well as the mechanisms they employ to alter the conditions in which they operate.

METHOD

Semi-structured interviews and a focus group workshop with managers of five initiatives in England that implemented recovery-oriented practice at the interface between mental health services and communities.

RESULTS

Our cross-sector initiatives shared a range of characteristics and employed mechanisms that created favourable conditions for recovery-oriented practice: strong social value and process (rather than performance) orientation; participatory approaches and shared decision-making; flat hierarchies; creating and seizing business opportunities; utilising networking and (social) marketing opportunities; risk-taking; valuing and supporting all members of their organisations; entrepreneurial and value-driven leadership.

CONCLUSION

Recovery-oriented practice takes place in certain organisational environments that importantly influence an individual's recovery. Our research highlights the need to consider organisational characteristics when evaluating recovery interventions as well as a broader shift of research towards understanding the environments in which people experience recovery as members of society, and how those can be altered.

摘要

背景

在许多国家,实施以康复为导向的精神卫生服务是政策重点。此外,一些政府优先考虑以更强的共同提供和社区参与为重点的新形式来组织、为精神卫生服务提供资金和管理。康复领域的大多数研究都集中在干预措施上。关于在精神卫生服务和社区之间的界面上实施以康复为导向的实践的组织特征以及它们用来改变其运作条件的机制,人们的了解有限。

目的

了解在精神卫生服务和社区之间的界面上实施以康复为导向的实践的举措的组织特征,以及它们用来改变其运作条件的机制。

方法

对英格兰五个在精神卫生服务和社区之间的界面上实施以康复为导向的实践的举措的管理人员进行半结构式访谈和焦点小组研讨会。

结果

我们的跨部门举措具有一系列共同的特征,并采用了创造有利于以康复为导向的实践的条件的机制:强烈的社会价值和过程(而不是绩效)导向;参与式方法和共同决策;扁平化层级;创造和抓住商业机会;利用网络和(社会)营销机会;承担风险;重视和支持组织内的所有成员;创业和以价值为导向的领导力。

结论

以康复为导向的实践发生在某些组织环境中,这些环境对个人的康复有重要影响。我们的研究强调了在评估康复干预措施时需要考虑组织特征,以及更广泛地将研究转向理解人们作为社会成员的康复环境以及如何改变这些环境。

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