Forchuk Cheryl, Martin Mary-Lou, Sherman Deborrah, Corring Deborah, Srivastava Rani, O'Regan Tony, Gyamfi Sebastian, Harerimana Boniface
1Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery, Lawson Health Research Institute, Mental Health Nursing Research Alliance, Parkwood Institute, Main Building 550 Wellington Road, Suite B3-110, P.O. Box 5777, STN B, London, N6A 4V2 Canada.
2Distinguished University Professor in the Arthur Labatt School of Nursing, Western University, London, Canada.
Int J Ment Health Syst. 2020 Mar 13;14:18. doi: 10.1186/s13033-020-00353-y. eCollection 2020.
Over the last three decades, there has been worldwide recognition of peer support contributions to improve mental healthcare provision. However, in the current literature, little attention has been paid to exploring perspectives of peer supporters on their involvement in mental health services provision. The purpose of the present study was to examine peer supporters' perspectives on the implementation of a transitional discharge model (TDM), an intervention for the community integration of people with mental illness.
This paper represents ethnographic qualitative data collected as part of a study that used mixed methods to evaluate the implementation of TDM across nine hospitals from the Province of Ontario, in Canada. The study involved a sample of 66 peer supporters, who were recruited from participating Consumer/Survivor Initiative Organizations and Peer Support Programs. The study collected data using two sets of focus groups, which were held at 6 months and 1-year post implementation. Data analysis used an ethnography model of qualitative analysis.
Peer supporters expressed that their involvement in mental healthcare enhanced clients' autonomy and hope about their recovery, as well as established a safety net and reduced hospital readmissions. Peer supporters articulated that they assumed several roles to facilitate clients' transition from hospital to the community. These roles included: assisting clients in building their capacity and developing healthy routines; attending regular on-ward and community meetings; accompanying clients to their appointments; and working with clients to set goals for their recovery. The study showed hindrances to effective implementation of peer support programs, such as a lack of understanding and appreciation of peer supporter roles, lack of careful allocation of peer supporters to clients, and an absence of appropriate protocols for ensuring the safety and supervision of the peer supporters.
Results of the TDM implementation demonstrated that involving peer supporters in mental healthcare delivery may benefit clients by enhancing autonomy and hope about their recovery, as well as establishing a safety net and reducing hospital readmissions. Results from the study have the potential to inform healthcare professionals and managers of strategies for developing effective peer support programs.
在过去三十年里，同伴支持对改善精神卫生保健服务的贡献已得到全球认可。然而，在当前文献中，很少有人关注探索同伴支持者对其参与精神卫生服务提供的看法。本研究的目的是考察同伴支持者对过渡性出院模式（TDM）实施情况的看法，TDM是一项促进精神病患者融入社区的干预措施。
本文呈现的是作为一项研究的一部分所收集的人种志定性数据，该研究采用混合方法评估了加拿大安大略省九家医院TDM的实施情况。该研究涉及66名同伴支持者样本，他们是从参与的消费者/幸存者倡议组织和同伴支持项目中招募的。该研究通过两组焦点小组收集数据，焦点小组分别在实施后的6个月和1年举行。数据分析采用人种志定性分析模型。
同伴支持者表示，他们参与精神卫生保健增强了服务对象的自主性以及对康复的希望，还建立了一个安全网并减少了再次入院情况。同伴支持者明确表示，他们承担了几个角色以促进服务对象从医院过渡到社区。这些角色包括：帮助服务对象增强能力并养成健康的日常习惯；参加定期的病房和社区会议；陪同服务对象就诊；以及与服务对象共同设定康复目标。该研究显示了同伴支持项目有效实施的障碍，例如对同伴支持者角色缺乏理解和认可、同伴支持者与服务对象的分配不够谨慎，以及缺乏确保同伴支持者安全和监督的适当规程。
TDM实施的结果表明，让同伴支持者参与精神卫生保健服务可能会使服务对象受益，增强他们的自主性以及对康复的希望，还建立一个安全网并减少再次入院情况。该研究结果有可能为医疗保健专业人员和管理人员提供制定有效同伴支持项目的策略依据。
