Norton Michael John
National Engagement and Recovery Lead, St. Loman's Hospital, Palmerstown, Dublin, Republic of Ireland.
Int J Ment Health Syst. 2023 Jan 26;17(1):1. doi: 10.1186/s13033-023-00570-1.
Mental health services are currently undergoing immense cultural, philosophical, and organisational change. One such mechanism involved in this change has been the recognition of lived experience as a knowledge subset in its own right. Within five Community Health Care Organisations [CHOs] in the Irish mental health services, 2017 marked a new era as the traditional statutory mental health service hired a total of 30 Peer Support Workers. Since then, additional Peer Support Workers were recruited along with the added addition of Family Peer Support Work. The purpose of such positions is to use their lived experiences and the knowledge subset within it to normalise experiences, break down hierarchical barriers and facilitate candid conversations that will allow the service user to progress on their own, self-defined recovery journey. Since it's inception into Irish mental health services, peer support has been line managed by a non-peer discipline. It is this where this paper highlights a potential problem. The paper raises concerns that the supervision conducted by these non-peer professionals could tamper, mutate and destroy the essence of peer support-the transfer and use of lived experience between service users. As such, a recommendation is suggested that the literature pauses discussions as to the mechanism by which lived experience is delivered and instead focus energies on identifying the ontological and epistemological position that underpins the experiences.One potential position to examine is that of constructionism as such knowledge is created or constructed through the fusion of life experiences and sub-concious thoughts and emotions experienced at a particular moment in time which are then entangled together with current information to create a narrative or story that can be therapeutic. It is through this philosophical exercise involviong/including existential themes that the essence of lived experience can be identified, protected, and nourished within mental health discourse.
心理健康服务目前正经历着巨大的文化、哲学和组织变革。这种变革所涉及的一个机制是,将生活经验本身视为一种知识子集而得到认可。在爱尔兰心理健康服务的五个社区医疗组织(CHOs)中,2017年标志着一个新时代的到来,因为传统的法定心理健康服务机构共雇佣了30名同伴支持工作者。从那时起,又招募了更多的同伴支持工作者,并增加了家庭同伴支持工作。这些职位的目的是利用他们的生活经验及其所含的知识子集,使各种经历正常化,打破等级障碍,并促进坦诚的对话,从而让服务使用者能够在他们自己定义的康复旅程中取得进展。自从同伴支持引入爱尔兰心理健康服务以来,一直由非同伴专业人员进行直线管理。而本文正是在此突出了一个潜在问题。该论文提出了担忧,即这些非同伴专业人员进行的监督可能会篡改、扭曲并破坏同伴支持的本质——服务使用者之间生活经验的传递和利用。因此,建议文献暂时停止关于生活经验传递机制的讨论,转而将精力集中在确定支撑这些经验的本体论和认识论立场上。一个值得审视的潜在立场是建构主义,因为此类知识是通过特定时刻所经历的生活经验与潜意识中的思想和情感相融合而创造或构建出来的,然后这些经验与当前信息交织在一起,形成一个具有治疗作用的叙述或故事。正是通过这种涉及/包括存在主义主题的哲学思考,生活经验的本质才能在心理健康话语中得到识别、保护和滋养。