The unique contribution of older people with a lived experience of mental illness to the peer workforce: observations from older peer workers
Abstract
Background: The development of peer work models that are integrated into health systems is at the heart of national and international reform agenda in mental health. Peer work differs from other mental health roles as it is provided by people who have a lived experience of mental illness and recovery and does not assume a medical model. Peer work in mental health services for older people is not well established and to address this gap we developed, implemented and evaluated a peer work model for older patients of a specialist mental health service.
Method: The findings discussed in this paper are part of a broader evaluation and consist of qualitative observations made by the peer workers during focus groups. Three focus groups were conducted during the first year of the project to identify the peer workers’ perspectives, feelings and thoughts around the developing peer work model and how they were impacted by the work. Data collection and analysis was inductive and informed by grounded theory principles. Observations from peer workers are discussed in relation to the literature as well as observations made by the researchers during project implementation.
Results: Analysis suggests that older peer workers have a level of maturity and experience with recovery that benefit the peer workforce in a number of ways namely (a) significant experience with recovery to draw on when helping others; (b) a well-established sense of identity and coping strategies that support wellbeing and (c) ability to cope with ambiguity and uncertainty inherent in peer work practice. We propose that having a strong sense of self or personal identity may be important in peer work, particularly as the peer work role is often challenged, questioned and unclear.
Conclusion: Older peer workers provide a valuable contribution to the peer workforce and bring with them an array of strengths that can help overcome some of the common peer work implementation barriers.
Keywords
Full Text:
PDFReferences
Health Workforce Australia. (2014). Mental Health Peer Workforce Literature Scan. available at: www.academia.edu/17145874/Mental_Health_Peer_Workforce_Literature_Scan.
Mental Health Commission. (2014). Living Well: Putting people at the centre of mental health reform in NSW. Sydney: NSW Mental Health Commission.
Commonwealth of Australia. (2013). A National Framework for Recovery-Oriented Mental Health Services - Policy and Theory. Australian Health Ministers Advisory Council. Available at: www.mhima.org.au/pdfs/Recovery%20Framework%202013_Policy_theory.pdf.
Orwin, D. (2008). Thematic Review of Peer Supports Literature review and leader interviews. Available at: www.thehub.superu.govt.nz/project/thematicv-review-peer-supports-literature-review-and-leader-interviews.
Proudfoot, J.G., Jayawant, A., Whitton, A.E., Parker. G., Manicavasagar, V., Smith, M. & Nicholas, J. (2012). Mechanisms underpinning effective peer support: a qualitative analysis of interactions between expert peers and patients newly-diagnosed with bipolar disorder. BMC Psychiatry 12, 196.
Repper, J. & Carter, T. (2011). A review of the literature on peer support in mental health services. Journal of Mental Health 20 (4) 392-411.
Jacobson, N., Trojanowski, L. & Dewa, C.S. (2012). What do peer support workers do? A job description. BMC Health Services Research 12, 205.
Solomon, P. (2004). Peer Support/Peer Provided Services Underlying Processes, Benefits and Critical Ingredients. Psychiatric Rehabilitation Journal. 27 (4) 392-401.
Miyamoto, Y. & Sono, T. (2012). Lessons from Peer Support Among Individuals with Mental Health Difficulties: A Review of the Literature. Clinical Practice and Epidemiology in Mental Health 8, 22-29.
Ochocka, J., Nelson, G., Janzen, R. & Trainor, J. (2006). A longitudinal study of mental health consumer/survivor initiatives: Part 3 - A qualitative study of impacts of participation on new members. Journal of Community Psychology 34 (3) 273-283.
Davidson, L., Chinman, M., Sells, D. & Rowe, M. (2006). Peer support among adults with serious mental illness: a report from the field. Schizophrenia Bulletin 32 (3) 443-450.
Pitt, V., Lowe, D., Hill, S., Prictor, M., Hetrick, S., Ryan, R. & Berends, L. (2013). Consumer providers of care for adult clients of statutory mental health services. Cochrane Database of Systematic Reviews (3) CD004807.
Davidson, L., Bellamy, C., Guy, K. & Miller, R. (2012). Peer support among persons with severe mental illnesses: a review of evidence and experience. World Psychiatry 11, 123-128.
Daley, S., Newton, D., Slade, M., Murray, J. & Banerjee, S. (2013). Development of a framework for recovery in older people with mental disorder. International Journal of Geriatric Psychiatry 28 (5) 522-529.
Chapin, R., Sergeant, J., Landry, S., Leedahal, S., Rachlin, R., Koenig, T. & Graham, A. (2013). Reclaimimg Joy: Pilot Evaluation of a Mental Health Peer Support Program for Older Adults Who Receive Medicaid. The Gerontologist 53 (2) 345-352.
Craig, T., Doherty, I. & Jamieson-Craig, R. (2004). The consumer-employee as a member of a Mental Health Assertive Outreach Team. Journal of Mental Health 15, 59-69.
Coates, D. & Howe, D. (2016). Integrating a youth participation model in a youth mental health service: Challenges and lessons learned. Child and Youth Services 37 (3) 287-300.
O'Donnell, M., Parker, G. & Proberts, M. (1999). A study of client focused case management and consumer advocacy: the Community and Consumer service Project. Australian and New Zealand Journal of Psychiatry 33, 684-693.
Rivera, J., Sullivan, A. & Valenti, S. (2007). Adding consumer-providers to intensive case management: Does it improve outcome? Psychiatric Services 58, 802-809.
Sells, D., Davidson, L. & Jewell, C. (2006). The treatment relationship in peer-based and regular case management for clients with severe mental illness. Psychiatric Services 57, 1179-1184.
Simmons, M., Coates, D., Batchelor, S., Dimopoulos, T. & Howe, D. (2017). The CHOICE Pilot Project: Challenges of implementing a combined peer work and shared decision making program in an early intervention service. Early Intervention Psychiatry. doi: 10.1111/eip.12527.
Hill, L., Roberts, G., Wildgoose, J., Perkins, R. & Hahn, S.A. (2010). Recovery and person-centred care in dementia: common purpose, common practice? Advances in Psychiatric Treatment 16, 288-298.
Coates, D., Livermore, P. & Green, R. (2018). The development and implementation of a peer support model for a specialist mental health service for older people: Lessons learned. Mental Health Review Journal In press.
Koshy, E., Koshy, V. & Waterman, H. (2011). Action Research in Healthcare. London: SAGE Publications.
Meyer, J. (2000). Using qualitative methods in health related action research. British Medical Journal 320 (7228) 178-181.
Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Research London: SAGE Publications 2006.
Corbin, J. & Strauss, A. (2014). Basics of qualitative research: Techniques and procedures for developing grounded theory. 4th edn. Thousand Oaks, CA: SAGE Publications.
Billinger, S., Fleisch, E., Friedli, T. & Rathje, M. (2004). Combining Action Research, Grounded Theory and Case Study Research within Long-term Research Projects. Available at: www.researchgate.net/publication/36384574.
Wilkinson, C.E., Rees, C.E. & Knight, L.V. (2007). "From the heart of my bottom": Negotiating humor in focus group discussions. Qualitative Health Research 17 (3) 411-422.
Wong, Y-L.I., Sands, R. & Solomon, P. (2010). Conceptualising Community: The Experience of Mental Health Patients. Qualitative Health Research 20 (5) 654-667.
Getrich, C.M., Bennett, A.M., Sussman, A.L., Solares, A. & Helitzer, D.L. (2016). Viewing Focus Groups Through a Critical Incident Lens. Qualitative Health Research 26 (6) 750-762.
Morgan, D.L. & Bottorff, J.L. (2010). Advancing Our Craft: Focus Group Methods and Practice. Qualitative Health Research 20 (5) 579-581.
Rothwell, E., Anderson, R. & Botkin, J.R. (2016). Deliberative Discussion Focus Groups. Qualitative Health Research 26 (6) 734-740.
Creswell, J.W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. California: SAGE Publications.
Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five approaches. Health Promotion Practice 16 (4) 473-475.
Bryant, A. & Charmaz, K. (2007). Grounded Theory Methods and Practices. In: The Sage Handbook of Grounded Theory, pp. 1-7. Bryant, A. & Charmaz, K., eds. Los Angeles: SAGE Publications.
Creswell, J.W. (1998). Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks: CA: SAGE Publications.
Charmaz, K. (2011). Grounded theory methods in social justice research. In: The Sage Handbook of Qualitative Research, pp. 359-380.Denzin, N.K. & Lincoln, Y.S. eds. Los Angeles, CA: SAGE Publications.
NSW Health. (2007). Human Research Ethics Committees - Quality Improvement & Ethical Review: A Practice Guide for NSW. Document number GL2007_020. North Sydney: NSW Health.
Health Records and Information Privacy Act. (2002). NSW Legislation No 71: NSW Government; 2002 Available from: http://www.legislation.nsw.gov.au/#/view/act/2002/71/full.
National Health and Medical Research Council. Ethical Considerations in Quality Assurance and Evaluation Activities 2014 Available from: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e111_ethical_considerations_in_quality_assurance_140326.pdf.
Morse, J.M. (2007). Ethics in action: ethical principles in doing qualitative health research. Qualitative Health Research. 17, 1003-1005.
Duncan, R., Drew, S., Hodgson, J. & Sawyer, S.M. (2009). Is my mum going to hear this? Methodological and ethical challenges in qualitative health research with young people. Social Science & Medicine 69, 1691-1699.
Leamy, M., Bird, V., le Boutillier, C., Williams, J. & Slade, M. (2011). A conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. British Journal of Psychiatry 199, 445-452.
Repper, J. (2013). Peer Support Workers: a practical guide to implementation - Implementing Recovery through Organisational Change. Centre for Mental Health and Mental Health Network, NHS Confederation 2013.
Canadian Mental Health Association. (2007). An Environmental Scan: Peer Support for Youth with Mental Health Problems and Their Families.
Salzer, M. & Shear, S. (2002). Identifying consumer-provider benefits in evaluations of consumer-delivered services. Psychiatric Rehabilitation Journal 25 (3) 281-288.
Ratzlaff, S., McDiarmid, D., Marty, D. & Rapp, C. (2006). The Kansas consumer as provider program: Measuring the effects of a supported education initiative. Psychiatric Rehabilitation Journal 29 (3) 174-182.
Bracke, P., Christiaens, W. & Verhaeghe, M. (2008). Self-esteem, self-efficacy, and the balance of peer support among persons with chronic mental health problems Journal of Applied Social Psychology 38 (2) 436-459.
McLean, J., Briggs, H., Whitehead, I., Pratt, R. & Maxwell, M. (2009). Evaluation of the delivering for mental health peer support worker pilot scheme. Edinburgh: Scottish Government.
Mombray, C., Moxley, D. & Collins, M. (1998). Consumer as mental health providers: First person accounts of benefits and limitations. Journal of Behavioural Health Services Research 25 (4) 397-411.
Berry, C., Hayward, M. & Chandler, R. (2011). Another rather than other: experiences of peer support specialist workers and their managers working in mental health services. Journal of Public Mental Health 10 (20) 238-249.
Moran, G., Russinova, Z., Gidugu, V., Yeon Yim, J. & Sprague, C. (2012). Benefits and Mechanisms of Recovery Among Peer Providers with Psychiatric Illnesses. Qualitative Health Research 22 (3) 304-319.
Faulkner, A. & Kalathil, J. (2012). The Freedom to be, the Chance to Dream: Preserving User-Led Peer Support in Mental Health. Commissioned by the Together Foundation, London.
Gillard, S., Edwards, C., Gibson, S.L., Owen, K. & Wright, C. (2013). Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges. BMC Health Services Research 13, 188.
Coleman, R. & Cambell, J. (2009). Roads to recovery peer development project: The first year. Ongoing evaluation of the development process. Working to Recovery Publications. Available at: www.workingtorecovery.co.uk.
Mead, S., Hilton, D. & Curtis, L. (2001). Peer Support: A Theoretical Perspective. Psychiatric Rehabilitation Journal 25 (2) 131-141.
Mental Health Coordinating Council. (2016). Mental Health Peer Work Qualification Development Project 2016, Accessed 8th of May 2017. Available from: http://www.mhcc.org.au/sector-development/workforce-development/peer-work-qualification-project.aspx.
Mental Health Commission. (2016). Employer's guide to implementing a peer workforce: Mental Health Commission, Peer Work Hub: Growing the Mental Health Workforce.
DOI: http://dx.doi.org/10.5750/ejpch.v6i1.1413
Refbacks
- There are currently no refbacks.