Mowbray C T, Moxley D P, Collins M E
School of Social Work, University of Michigan, Ann Arbor 48109-1106, USA.
J Behav Health Serv Res. 1998 Nov;25(4):397-411. doi: 10.1007/BF02287510.
Community support programs are increasingly establishing paid service positions designated exclusively for consumers. Project WINS (Work Incentives and Needs Study), a hybrid case management-vocational program for individuals with severe mental illness, used consumers as peer support specialists (PSSs) to supplement professional roles. Semistructured interviews were conducted with PSSs about 12 months after their employment ended. They identified substantial personal benefits specific to consumer-designated roles (e.g., a "safe" employment setting with accommodations) and general benefits from employment. Problems described were just as numerous, encompassing attitudes toward assigned peers and costs to their own well-being. Critical commentary addressed program operations (structure, supervision, and training needs) and problems in the mental health system. The authors discuss the changed sense of self that service provider roles can create for consumers and suggest that mental health administrators provide anticipatory socialization for this service innovation throughout their agencies and ongoing supports for consumers in their new roles.
社区支持项目越来越多地设立专门为消费者指定的带薪服务岗位。“WINS项目”（工作激励与需求研究）是一个针对重度精神疾病患者的混合式个案管理-职业项目，该项目将消费者用作同伴支持专家（PSS）以补充专业角色。在PSS就业结束约12个月后，对他们进行了半结构化访谈。他们确定了消费者指定角色所特有的大量个人益处（例如，一个有便利设施的“安全”就业环境）以及就业带来的一般益处。所描述的问题同样众多，包括对指定同伴的态度以及对自身幸福感的影响。批判性评论涉及项目运营（结构、监督和培训需求）以及心理健康系统中的问题。作者讨论了服务提供者角色可能为消费者带来的自我认知的改变，并建议心理健康管理人员在其整个机构中为这项服务创新提供预期社会化，并为担任新角色的消费者提供持续支持。
