Pires de Oliveira Padilha Paula, Gagné Geneviève, Iyer Srividya N, Thibeault Esther, Levasseur Mary Anne, Massicotte Hélène, Abdel-Baki Amal
Département de psychiatrie et d'addictologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Québec, Canada.
Centre hospitalier de l'Université de Montréal, Québec, Canada ; Centre de recherche du Centre hospitalier de l'Université de Montréal, Québec, Canada.
Sante Ment Que. 2023 Spring;48(1):167-206.
Objectives To describe the different issues surrounding the integration of peer support workers (PSW) and family peer support workers (FPSW) into early intervention for psychosis services (EIS): their roles, the impacts of these interventions for patients, their families, and treatment teams, as well as the challenges and facilitators of this process. Method This article, co-authored with PSW and FPSW, presents a description and discussion of the experience of implementing peer support and family peer support in EIS in Québec, supported by a perspective of a review of the scientific and grey literature published in French or English in the last twenty years. Results Eight of the 36 scientific articles and two of the 14 grey literature publications selected were specific to early intervention for psychosis; the remainder were on mental health intervention. These publications put into context the experience described by clinicians, PSW and FPSW, and illustrated by clinical vignettes. Different modalities of peer support have demonstrated a positive impact on young people with early psychosis: it contributes to the improvement of self-esteem, quality of life, emotional well-being and can facilitate the rehabilitation process and reduce hospitalizations. Family peer support can reduce the stigma surrounding mental health problems, foster hope and a sense of belonging, increase knowledge of the illness and its treatment, and promote better coping strategies by family members. Nevertheless, many challenges have been identified during the integration of peer support and family peer support within clinical teams: planning and funding the implementation of services, defining their roles in EIS, training, clinical supervision, etc. These challenges need to be identified and addressed quickly in order to optimize care for youth and their families. Various strategies have been proposed for the successful implementation of peer support in EIS, which remains limited in Quebec and in the French-speaking world. It requires the participation and support of all stakeholders, including health professionals, managers and decision makers. Conclusion Peer support and family peer support emphasizes lived experience as expertise, recognizing the contribution of people with psychosis and their families as sources of support and models for recovery. This perspective fits well with the philosophy advocated by EIS. This promising intervention, which has been put forward by various national policies or guides, would benefit from being rapidly implemented on a larger scale in Quebec EIS and in the French-speaking world. This would make it possible to study the positive impacts described for service users and their families with more rigorous research designs and larger samples.
目标 描述围绕同伴支持工作者（PSW）和家庭同伴支持工作者（FPSW）融入精神病早期干预服务（EIS）的不同问题：他们的角色、这些干预措施对患者、其家庭和治疗团队的影响，以及这一过程中的挑战和促进因素。方法 本文与PSW和FPSW共同撰写，在对过去二十年以法语或英语发表的科学文献和灰色文献进行综述的视角支持下，描述并讨论了在魁北克的EIS中实施同伴支持和家庭同伴支持的经验。结果 所选的36篇科学文章中的8篇和14篇灰色文献出版物中的2篇专门针对精神病早期干预；其余的是关于心理健康干预的。这些出版物将临床医生、PSW和FPSW所描述的经验置于背景中，并通过临床案例进行说明。不同形式的同伴支持已证明对患有早期精神病的年轻人有积极影响：它有助于提高自尊、生活质量、情绪健康，并能促进康复过程和减少住院次数。家庭同伴支持可以减少围绕心理健康问题的污名，培养希望和归属感，增加对疾病及其治疗的了解，并促进家庭成员更好的应对策略。然而，在临床团队中整合同伴支持和家庭同伴支持的过程中发现了许多挑战：服务实施的规划和资金、在EIS中定义他们的角色、培训、临床监督等。为了优化对青少年及其家庭的护理，需要迅速识别并解决这些挑战。已提出各种策略以在EIS中成功实施同伴支持，这在魁北克和法语世界仍然有限。它需要所有利益相关者的参与和支持，包括卫生专业人员、管理人员和决策者。结论 同伴支持和家庭同伴支持强调生活经验即专业知识，认识到精神病患者及其家庭作为支持来源和康复榜样的贡献。这种观点与EIS所倡导的理念非常契合。这种有前景的干预措施已被各种国家政策或指南提出，将受益于在魁北克EIS和法语世界更快地大规模实施。这将有可能通过更严谨的研究设计和更大的样本研究对服务使用者及其家庭所描述的积极影响。
