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DOI: 10.1055/a-2361-4057
„Change Agents“ oder „Peer Washing“: inwiefern können Peer- und Genesungsbegleiter*innen zur Veränderung von psychiatrischen Einrichtungen beitragen?
“Change Agents” Or “Peer Washing”: Can Peer Support Workers Contribute To The Transformation Of Psychiatric Institutions? Fördermittel German Innovation Fund — 01VSF19042
Zusammenfassung
Ziel Von Peer- und Genesungsbegleiter*innen (=PGB*) wird erwartet, die Kultur einer Versorgungseinrichtung zu verändern. Diese Arbeit untersucht, ob und wie sich ein solcher Veränderungsauftrag umsetzen lässt.
Methoden Das Material speist sich aus zwei Teilen der ImpPeer-Psy5-Studie, die bundesweit die PGB*-Implementierung in der krankenkassenfinanzierten Versorgung untersucht. Daten aus 57 problemzentrierten Interviews und zwei Fokusgruppen wurden mit der thematischen Analyse analysiert.
Ergebnisse PGB*benötigen Mut und Ausdauer, auch weil ihre Veränderungsimpulse unzureichend aufgenommen werden. Das kann zur Wiederholung von Ausschlusserfahrungen führen und dazu, dass PGB*sich an Handlungsweisen und Haltungen der Teams anpassen.
Schlussfolgerungen Damit PGB*Veränderungsimpulse einbringen können, sollte sich eine Einrichtung selbstständig auf einen Veränderungsweg begeben haben, Machtverhältnisse und strukturelle Diskriminierung sollten reflektiert, Austauschräume und eine Kritikkultur etabliert, und genug Zeit für die Implementierung von PGB*eingeräumt werden.
Abstract
Objective Peer support workers (=PSW) are expected to change the culture of a care facility. It is examined whether and how they can implement such a change mandate.
Methods The material is based on two sub-studies of the ImpPeer-Psy5 study, investigating the implementation of PSW in the German psychiatric care system. Data from 57 problem-centered interviews and two focus groups were analyzed using a thematic analysis.
Results PSW need courage, also as their impulses for change are often insufficiently received. This can lead to the reproduction of exclusion and to the PSWs’ adaption to the attitudes of the teams.
Conclusions To facilitate the implementation of the PSWs’ change mandate, power relations and structural discrimination should be reflected, exchange spaces and a culture of critique should be established, and enough time be allowed for the implementation of PSW.
Publication History
Received: 04 January 2024
Accepted: 07 July 2024
Article published online:
19 August 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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Literatur
- 1 Peer Counseling – Peer Support. Isl-ev.de. Im Internet: https://www.isl- ev.de/index.php/themen/peer-counseling Stand: 07.01.2023
- 2 UPSIDES. Im Internet: https://www.upsides.org/ Stand: 07.01.2023
- 3 Link A. SY. Hilfe von Betroffenen für Betroffene. Dachverband DBT eV. Im Internet: https://dachverband-dbt.de/dbt_peer_coachin Stand: 07.03.2023
- 4 von Peter S, Kraemer UM, Cubellis L, Fehler L, Ruiz-Perez G, Schmidt D, Ziegenhagen J, Kuesel M, Ackers S, Mahlke C, Nugent L, Heuer I. Implementing peer support in mental health care in Germany: the methodological framework of the collaborative, participatiory, mixed methods study (ImpPeer-Psy5). Health Expectations 2024; 27: e 12938 https://onlinelibrary.wiley.com/doi/full/
- 5 Mahlke CI, Priebe S, Heumann K. et al. Effectiveness of one-to-one peer support for patients with severe mental illness – a randomised controlled trial. Eur Psychiatry 2017; 42: 103-110
- 6 Aguey-Zinsou M, Sommer J. Staff Attitudes Towards Consumer Participation and Peer Worker Roles in a Community Mental Health Service. Community Mental Health Service Journal of Recovery in Mental Health 2018; 2: 2371-2376
- 7 Ahmed AO, Hunter KM, Mabe AP. et al. The professional experiences of peer specialists in the Georgia Mental Health Consumer Network. Community Ment Health J 2015; 51: 424-436
- 8 Moore T, Zeeman L. More „milk“ than „psychology or tablets“: Mental health professionals’ perspectives on the value of peer support workers. Health Expect 2021; 24: 234-242
- 9 Chinman M, McInnes DK, Eisen S. et al. Establishing a research agenda for understanding the role and impact of mental health peer specialists. Psychiatr Serv 2017; 68: 955-957
- 10 Cubellis L. Care wounds: Precarious vulnerability and the potential of exposure. Cult Med Psychiatry 2018; 42: 628-646
- 11 Practice Guidelines for Peer Support Purpose. Kingcounty.gov. Im Internet: https://kingcounty.gov/~/media/depts/community-human-services/behavioral-health- recovery/documents/Provider%20Manual%20Attachments/13_C_BH- ASO_Practice_Guidelines_for_Peer_Support.ashx?la=en Stand: 16.11.2023
- 12 Asad S, Chreim S. Peer support providers’ role experiences on interprofessional mental health care teams: A qualitative study. Community Ment Health J 2016; 52: 767-774
- 13 Gillard S, Gibson SL, Holley J. et al. Developing a change model for peer worker interventions in mental health services: a qualitative research study. Epidemiol Psychiatr Sci 2015; 24: 435-445
- 14 Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 2017. Third Edition. Sage Publication;
- 15 von Peter S. Partizipative und kollaborative Forschungsansätze in der Psychiatrie. Psychiat Prax 2017; 44: 431-433
- 16 Sweeney A, Greenwood KE, Williams S, Wykes T, Rose DS. Hearing the voices of service user researchers in collaborative qualitative data analysis: the case for multiple coding. Health Expect 2013; 16: e89-e99
- 17 Gillard S, Borschmann R, Turner K, Goodrich-Purnell N, Lovell K, Chambers M. Producing different analytical narratives, coproducing integrated analytical narrative: a qualitative study of UK detained mental health patient experience involving service user researchers. Int J Soc Res Methodol. 2012; 15: 239-254
- 18 Braun V, Clarke V. Thematic analysis: A practical guide. London, England: SAGE Publications; 2021
- 19 Simpson A, Oster C, Muir-Cochrane E. Liminality in the occupational identity of mental health peer support workers: A qualitative study. Int J Ment Health Nurs 2018; 27: 662-671
- 20 Voronka J. Turning mad knowledge into affective labor: The case of the peer support worker. Am Q 2017; 69: 333-338
- 21 Gillard SG, Edwards C, Gibson SL. et al. Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges. BMC Health Serv Res 2013; 13
- 22 Happell B, Bennetts W, Platania-Phung C. et al. Consumer involvement in mental health education for health professionals: feasibility and support for the role. J Clin Nurs 2015; 24: 3584-3593
- 23 Jones N, Kosyluk K, Gius B. et al. Investigating the mobility of the peer specialist workforce in the United States: Findings from a national survey. Psychiatr Rehabil J 2020; 43: 179-188
- 24 Järvinen M, Kessing ML. Self-casting and alter-casting: Healthcare professionals’ boundary work in response to peer workers. Curr Sociol 2023; 71: 414-431
- 25 Mancini MA. An exploration of factors that effect the implementation of peer support services in community mental health settings. Community Ment Health J 2018; 54: 127-137
- 26 Ibrahim N, Thompson D, Nixdorf R. et al. A systematic review of influences on implementation of peer support work for adults with mental health problems. Soc Psychiatry Psychiatr Epidemiol 2020; 55: 285-293
- 27 https://ex-in.de/wp-content/uploads/2021/03/Curriculum-EX-IN-Kurzfassung-mit-Hinweis.pdf
- 28 Utschakowski J. Mit Peers arbeiten: Leitfaden für die Beschäftigung von Experten aus Erfahrung. Köln: Psychiatrie Verlag; 2015
- 29 Kupers W, Weibler J. Emotionen in Organisationen. Kohlhammer; 2005
- 30 Hochschild AR. Das gekaufte Herz: Zur Kommerzialisierung der Gefühle. 1. Aufl. Frankfurt: Campus; 1990
- 31 Walsh PE, McMillan SS, Stewart V. et al. Understanding paid peer support in mental health. Disabil Soc 2018; 33: 579-597
- 32 Beeker T, Mills C, Bhugra D. et al. Psychiatrization of society: A conceptual framework and call for transdisciplinary research. Front Psychiatry 2021; 12
- 33 Rimke H. Introduction – mental and emotional distress as a social justice issue: Beyond psychocentrism. Stud Soc Justice 2016; 10: 4-17
- 34 Peer Support toolkit. Dbhids.org. Im Internet: https://dbhids.org/wp- content/uploads/1970/01/PCCI_Peer-Support-Toolkit.pdf Stand: 16.11.2023
- 35 Alberta AJ, Ploski RR. Cooptation of peer support staff: Quantitative evidence. Rehabil Proc.outcome 2014; 3 RPO.S12343
- 36 Mead S, Hilton D, Curtis L. Peer support: A theoretical perspective. Psychiatr Rehabil J 2001; 25: 134-141
- 37 Brown M, Jones N. Service user participation within the mental health system: Deepening engagement. Psychiatr Serv 2021; 72: 963-965
- 38 Penney D. Defining “peer support”: Implications for policy, practice, and research. Mamh.org. Im Internet: https://www.mamh.org/assets/files/DPenney_Defining_peer_support_2018_Final.pdf Stand: 16.11.2023
- 39 Adams WE. Unintended consequences of institutionalizing peer support work in mental healthcare. Soc Sci Med 2020; 262: 113249
- 40 Stamou E. Reclaiming user leadership in peer support practice. J Ment Health Train Educ Pract 2014; 9: 167-176
- 41 Grey F. Benevolent othering: Speaking positively about mental health service users. Philos Psychiatr Psychol 2016; 23: 241-251
- 42 Sinclair A, Gillieatt S, Fernandes C. et al. Inclusion as assimilation, integration, or co- optation? A post-structural analysis of inclusion as produced through mental health research on peer support. Qual Health Res 2023; 33: 543-555