Ruiz-Pérez Guillermo, Küsel Madeleine, von Peter Sebastian
Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany.
PLoS One. 2025 Apr 1;20(4):e0319830. doi: 10.1371/journal.pone.0319830. eCollection 2025.
The integration of Peer Support Workers (PSWs) in mental health settings may encounter resistance due to the attitudes of Mental Health Workers (MHWs). At the same time, PSWs may initiate changes in the attitudes, as well as in the larger institutional culture. This paper addresses the question of which changes happen and how they occur.
This work is part of the ImpPeer-Psy5 study, funded by the German Innovation Fund, which examines the nationwide implementation of PSWs in health insurance-funded mental health care. Data were derived from two qualitative sub-studies: QUAL1encompassed 57 problem-centered interviews conducted with PSWs, MHWs working together with PSWs, and service users; QUAL2 consisted of one focus group and five interviews only with MHWs. Qualitative data were analyzed using a modified thematic analysis adapted to a collaborative research approach.
The main findings included that working with PSWs makes MHWs better integrate lived experience insights into their caregiving, pay more attention to life contexts, advance towards a more appreciative language, use diagnostic categories more flexibly, and show more openness towards their own affectedness. These changes are reported to be mediated by the simple presence of PSWs, their "role model" function for other staff, or more direct forms of feedback and critique.
Overall, staff attitudes changed as a result of reflexive processes induced by their interactions with PSWs. This poses a dilemma as changes in MHWs and larger institutions are expected to occur prior to the implementation of peer support work to facilitate their integration. Further research is needed to evaluate whether and how staff training can facilitate the implementation of PSWs by targeting MHWs' attitudes.
在心理健康环境中引入同伴支持工作者（PSW）可能会因心理健康工作者（MHW）的态度而遭遇阻力。与此同时，同伴支持工作者可能会促使态度发生改变，以及在更大的机构文化中带来变化。本文探讨会发生哪些变化以及这些变化是如何发生的问题。
这项工作是由德国创新基金资助的ImpPeer-Psy5研究的一部分，该研究考察了在医疗保险资助的心理健康护理中同伴支持工作者在全国范围内的实施情况。数据来自两项定性子研究：QUAL1包括对同伴支持工作者、与同伴支持工作者合作的心理健康工作者以及服务使用者进行的57次以问题为中心的访谈；QUAL2由一个焦点小组和仅针对心理健康工作者的五次访谈组成。定性数据采用适合合作研究方法的改良主题分析法进行分析。
主要研究结果包括，与同伴支持工作者合作使心理健康工作者能够更好地将实际生活经验见解融入其护理工作中，更加关注生活背景，朝着更具欣赏性的语言发展，更灵活地使用诊断类别，并对自身的情感状态表现出更多开放性。据报告，这些变化是由同伴支持工作者的简单存在、他们对其他工作人员的“榜样”作用，或更直接的反馈和批评形式介导的。
总体而言，工作人员的态度因与同伴支持工作者互动引发的反思过程而发生了变化。这带来了一个两难困境，因为预计在同伴支持工作实施之前，心理健康工作者和更大的机构就会发生变化，以促进其整合。需要进一步研究来评估针对心理健康工作者的态度，员工培训是否以及如何能够促进同伴支持工作者的实施。
