Kessing Malene Lue
Department of Sociology, University of Copenhagen, Copenhagen, Denmark.
The Danish Center for Social Science Research, Copenhagen, Denmark.
Health Sociol Rev. 2022 Mar;31(1):32-46. doi: 10.1080/14461242.2020.1865183. Epub 2021 Jan 19.
Mental health services are increasingly employing peer workers (PWs), individuals who have lived experiences with mental health problems, to support patients and be part of mental health care teams. While the employment of PWs continues to increase, little is known about how the function unfolds in practice. This paper explores the broader context in which the PWs navigate and the concrete outcomes and everyday issues that exist at the individual level. Methodologically, the paper draws on 22 interviews with PWs employed in the mental health services in Denmark. Theoretically, it combines Lipsky's (1980) theory on street-level bureaucrats with sociological discussions concerning the lay-expert divide. The analysis shows that PWs experience both role ambiguity and goal uncertainty and that they use substantial discretion in determining the nature, amount and quality of their peer practices. This - combined with the PWs' diverse lived experiences - calls for a heterogeneous understanding of peer work and therefore the analysis presents three categories of peer workers: PWs as (1) a representative of patients' lifeworld, (2) an interdisciplinary professional and (3) an 'expert by experience'. These categories display PWs different enactments of their lived experiences and reveal ambiguities tied to the lay-expert divide.
心理健康服务机构越来越多地聘用同伴工作者（PW），即那些有过心理健康问题经历的人，来支持患者并成为心理健康护理团队的一员。虽然同伴工作者的聘用人数持续增加，但对于其在实际工作中如何发挥作用却知之甚少。本文探讨了同伴工作者所处的更广泛背景，以及个体层面存在的具体成果和日常问题。在方法论上，本文借鉴了对丹麦心理健康服务机构聘用的22名同伴工作者的访谈。在理论上，它将利普斯基（1980）关于街头官僚的理论与有关外行-专家分歧的社会学讨论相结合。分析表明，同伴工作者既经历了角色模糊和目标不确定的情况，而且在确定其同伴实践的性质、数量和质量方面有很大的自由裁量权。这一点，再加上同伴工作者多样的生活经历，需要对同伴工作有一个多样化的理解，因此分析提出了三类同伴工作者：同伴工作者作为（1）患者生活世界的代表，（2）跨学科专业人员，以及（3）“经验专家”。这些类别展示了同伴工作者对其生活经历的不同表现，并揭示了与外行-专家分歧相关的模糊性。
