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让无家可归的成年人参与康复教育:对个人和项目层面促进因素的定性分析。

Engaging Adults Experiencing Homelessness in Recovery Education: A Qualitative Analysis of Individual and Program Level Enabling Factors.

作者信息

Khan Bushra M, Reid Nadine, Brown Rebecca, Kozloff Nicole, Stergiopoulos Vicky

机构信息

Centre for Addiction and Mental Health, Toronto, ON, Canada.

Department of Psychiatry, University of Toronto, Toronto, ON, Canada.

出版信息

Front Psychiatry. 2020 Aug 6;11:779. doi: 10.3389/fpsyt.2020.00779. eCollection 2020.

Abstract

PURPOSE

Recovery Education Centres (REC) in mental health offer a new model of providing recovery supports through emancipatory adult education and recovery-oriented service principles. Despite the widespread adoption of RECs, there is limited evidence regarding factors enabling engagement and participation, particularly for unique subpopulations or service delivery contexts. The Supporting Transitions and Recovery Learning Centre (STAR) in Toronto, Ontario is the first REC in Canada and one of few worldwide supporting adults transitioning out of homelessness. This research aimed to investigate individual and program level enablers of engagement and participation in a REC for this population.

METHODS

Qualitative methods were used to explore the experiences of 20 service user participants through semi-structured interviews exploring their experiences of REC participation and perceived key program features. Interviews were conducted between July 2017 and June 2018, six to 14 months following REC enrollment, and analyzed using inductive thematic analysis.

RESULTS

In contrast to past experiences with health and social services, participants described a welcoming and respectful physical and interpersonal environment with low-barrier seamless access facilitating their engagement and participation. Although the realities of homelessness presented barriers for some, participants described that the involvement of peers, as role models, and the self-directed, strengths, and skills-based curriculum, co-produced and co-delivered by peers and professionals, were instrumental in activating the process of recovery through education.

CONCLUSIONS/IMPLICATIONS: Findings are consistent with the growing evidence base of the defining features of RECs and suggest this model can be successfully extended to support recovery among adults transitioning out of homelessness. This unique examination of Canada's first REC for adults exiting homelessness can help guide program and policy development to better support this disadvantaged population.

摘要

目的

心理健康康复教育中心(REC)提供了一种通过解放式成人教育和以康复为导向的服务原则来提供康复支持的新模式。尽管REC已被广泛采用,但关于促使人们参与其中的因素的证据有限,尤其是针对独特的亚群体或服务提供背景。安大略省多伦多市的支持过渡与康复学习中心(STAR)是加拿大首个REC,也是全球为数不多的支持无家可归者过渡到有住房生活的成人的机构之一。本研究旨在调查该人群参与REC的个人层面和项目层面的促进因素。

方法

采用定性方法,通过半结构化访谈探讨20名服务使用者参与者的经历,访谈内容涉及他们参与REC的体验以及感知到的关键项目特征。访谈于2017年7月至2018年6月进行,即REC入学后的6至14个月,并采用归纳主题分析法进行分析。

结果

与过去在健康和社会服务方面的经历不同,参与者描述了一个温馨且相互尊重的物理和人际环境,无障碍的无缝接入便利了他们的参与。尽管无家可归的现实给一些人带来了障碍,但参与者表示,同伴作为榜样的参与,以及由同伴和专业人员共同制作和共同提供的以自我导向、优势和技能为基础的课程,有助于通过教育激活康复过程。

结论/启示:研究结果与越来越多关于REC定义特征的证据一致,并表明该模式可以成功扩展,以支持从无家可归状态过渡出来的成年人的康复。对加拿大首个针对无家可归成年人的REC的这一独特考察,有助于指导项目和政策制定,以更好地支持这一弱势群体。

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