Skip to main content

Advertisement

SpringerLink
Log in

Developing Strategies to Integrate Peer Providers into the Staff of Mental Health Agencies

  • Original Paper
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

This study informs new strategies that promote integration of peer providers into the staff of social service agencies. Executive directors, human resource managers, supervisors and co-workers at 27 agencies in New York City were interviewed in-depth. Focus groups with peers were conducted. Consistent with previous research, respondents identified attitudes toward recovery, role conflict and confusion, lack of policies and practices around confidentiality, poorly defined job structure and lack of support as problems that undermined integration. Emerging from the data are strategies related to human resource policies and practices and workgroup relationships and operations that can improve employment of peer staff.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Akabas, S. H. (1994). Workplace responsiveness: Key employer characteristics in support of job maintenance for persons with mental illness. The Psychosocial Rehabilitation Journal, 17(3), 91–101

    Google Scholar 

  • Akabas, S. H. & Kurzman, P. (2005). Work and the workplace: A resource for innovative policy and practice New York: Columbia University Press

    Google Scholar 

  • Alley, S., & Blanton, J. (1976). A study of paraprofessionals in mental health. Community Mental Health Journal, 12(2), 151–160

    Article  PubMed  CAS  Google Scholar 

  • Anthony, W. A. (2000). A recovery-oriented service system: Setting some system level standards. Psychiatric Rehabilitation Journal, 24(2), 159–168

    Google Scholar 

  • Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11–23

    Google Scholar 

  • Armstrong, M. L., Korba, A. M., & Emard, R. (1995). Of mutual benefit: The reciprocal relationship between consumer volunteers and the clients they serve. Psychiatric Rehabilitation Journal, 19(2), 45–49

    Google Scholar 

  • Besio, S. W., & Mahler, J. (1993). Benefits and challenges of using consumer staff in supported housing services. Hospital and Community Psychiatry, 44(5), 490–491

    PubMed  CAS  Google Scholar 

  • Carlson, L. S., Rapp, C. A., & McDiarmid, D. (2001). Hiring consumer-providers: Barriers and alternative solutions. Community Mental Health Journal, 37(3), 199–213

    Article  PubMed  CAS  Google Scholar 

  • Chinman, M. J., Rosenheck, R., Lam, J. A., & Davidson, L. (2000). Comparing consumer and nonconsumer provided case management services for homeless persons with serious mental illness. The Journal of Nervous and Mental Disease, 188(7), 446–453

    Article  PubMed  CAS  Google Scholar 

  • Chinman, M., Young, A. S., Hassell, J. & Davidson, L. (2006). Toward the implementation of mental health consumer provider services. Journal of Behavioral Health Services & Research, 33 (2), 176–195

    Article  Google Scholar 

  • Clarke, G. N., Herinckx, H. A., Kinney, R. F., Paulson, P. I., Cutler, D. L., Lewis, K., & Oxman, E. (2000). Psychiatric hospitalizations, arrests, emergency room visits, and homelessness of clients with serious and persistent mental illness: Findings from a randomized trial of two ACT programs vs. usual care. Mental Health Services Research, 2(3),155–164

    Article  CAS  Google Scholar 

  • Comer, E., Meier, A., & Galinsky, M. (2004). Development of innovative group work practice using the intervention research paradigm. Social Work, 49(2), 250–260

    PubMed  Google Scholar 

  • Corrigan, P. W., & Phelan, S. M. (2004). Social support and recovery in people with serious mental illnesses. Community Mental Health Journal, 40(6), 513–523

    Article  Google Scholar 

  • Davidson, L., Chinman, M., Kloos, B., Weingarten, R., Stayner, D., & Tebes, J. K., (1999). Peer support among individuals with severe mental illness: a review of the evidence. Clinical Psychology; Science and Practice, 6(2), 165–187

    Article  Google Scholar 

  • Davidson, L., Weingarten, R., Steiner, J., Stayner, D., & Hoge, M. A. (1997). Integrating prosumers in clinical settings. In C. T. Mowbray, D. P. Moxley, C.A. Jasper, & L. L. Howell (Eds.), Consumers as providers in psychiatric rehabilitation(pp 437–455). Columbia, MD: International Association of Psychosocial Rehabilitation Services

    Google Scholar 

  • Deegan, P. E.(1992). The independent living movement and people with psychiatric disabilities. Taking back control over our own lives. Psychosocial Rehabilitation Journal, 15(3), 3–19

    Google Scholar 

  • Deegan, G. (2003). Discovering recovery. Psychiatric Rehabilitation Journal, 26(4), 368–376

    Article  PubMed  Google Scholar 

  • Delworth, U. (1974). Paraprofessionals as guerillas: Recommendations for system change. Personnel and Guidance Journal, 53, 335–338

    Google Scholar 

  • Dixon, L., Krauss, N., & Lehman, A. (1994). Consumers as service providers: The promise and the challenge. Community Mental Health Journal, 30(6), 615–625

    Article  PubMed  CAS  Google Scholar 

  • Felton, C. J., Stastny, P., Shern, D. L., Blanch, A., Donahue, S. A., Knight, E., & Brown, C. (1995). Consumers as peer specialists on intensive case management teams: Impact on client outcomes. Psychiatric Services, 46(10), 1037–1044

    PubMed  CAS  Google Scholar 

  • Field, S. H., & Gatewood, R. (1976). The paraprofessional and the organization: Some problems of mutual adjustment. Personnel and Guidance Journal, 55, 181–186

    Google Scholar 

  • Fisher, D. (2003). People are more important than pills in recovery from mental disorder. Journal of Humanistic Psychology, 43(2), 65–68

    Article  Google Scholar 

  • Fisk, D., Rowe, M., Brooks, M., & Gildersleeve, D. (2000). Integrating consumer staff members into a homeless outreach project: Critical issues and strategies. Psychiatric Rehabilitation Journal, 23(3), 244–252

    Google Scholar 

  • Furukawa, T. A., Harai, H., Hirai, T., Kitamura, T., & Takahashi, K. (1999). Social support questionnaire among psychiatric patients with various diagnoses and normal controls. Social Psychiatry and Psychiatric Epidemiology, 34(4), 213–222

    Article  Google Scholar 

  • Gates L. B., Akabas S. H., & Oran-Sabia V. (Winter 1998) Relationship accommodations involving the work group: Improving work prognosis for persons with mental health conditions. Psychiatric Rehabilitation Journal 21,(3):264–272

    Google Scholar 

  • Hohmann, A. A., & Shear, M. K. (2003). Community-based intervention research: Coping with the “noise” of real life in study design. The American Journal of Psychiatry, 159(2), 201–206

    Article  Google Scholar 

  • House, J. S. (1981). Work stress and social support Reading, MA: Addison-Wesley Publishing Co

    Google Scholar 

  • Huxham, C., & Vangen, S. (2003). Researching organizational practice through action research: Case studies and design choices. Organizational Research Methods, 6(3), 383–403

    Article  Google Scholar 

  • Jonikas, J. A., Solomon, M. L., & Cook, J. A. (1997). An inclusion framework: Preparing psychosocial rehabilitation programs and staff for the consumer hiring initiative. In C. T. Mowbray, D. P. Moxley, C. A. Japser, & L. L. Howell (Eds.), Consumers as providers in psychiatric rehabilitation (pp. 419–436). Columbia, MD: International Association of Psychosocial Rehabilitation Services

    Google Scholar 

  • Kaufmann, D. L., Schulberg, H. C., & Schooler, N. R. (1994). Self help group participation among people with seer mental illness. Prevention in Human Services, 11, 315–331

    Google Scholar 

  • Klien, A. R., Cnaan, R. A., & Whitecraft, J. (1998). Significance of peer social support with dually diagnosed clients: Findings from a pilot study. Research on Social Work Practice, 8(5), 529–551

    Article  Google Scholar 

  • Kurzman, P.A. (1990). The new careers movement and social change. Social Casework, 51, 22–27

    Google Scholar 

  • Lyons, J. S., Cook, J. A., Ruth, A. R., Karver, M., & Slag, N. B. (1996). Service delivery using consumer staff in a mobile crisis assessment program. Community Mental Health Journal, 32(1), 33–40

    Article  PubMed  CAS  Google Scholar 

  • Manning, S. S., & Suire, B. (1996). Consumers as employees in mental health: Bridges and roadblocks. Psychiatric Services, 47(9), 939–943

    PubMed  CAS  Google Scholar 

  • Markowitz, F. E. (2001) Modeling processes in recovery from mental illness: Relationships between symptoms, life satisfaction, and self-concept. Journal of Health and Social Behavior, 42(1), 64–79

    Article  PubMed  CAS  Google Scholar 

  • Miles, M. B. & Huberman, A. M. (1994). Qualitative data analysis (2nd. Ed.). Thousand Oaks, CA: Sage

    Google Scholar 

  • Miya, K., Wilbur, S., Crocker, B., & Compton, F. (1997). Addressing and resolving role issues between professionals and consumer employees. In C. T. Mowbray, D. P. Moxley, C. A. Japser, & L. L. Howell (Eds.), Consumers as providers in psychiatric rehabilitation (pp.334–346). Columbia, MD: International Association of Psychosocial Rehabilitation Services

    Google Scholar 

  • Mowbray, C. T. (1997). Benefits and issues created by consumer role innovation in psychiatric rehabilitation. In C. T. Mowbray, D. P. Moxley, C. A. Japser, & L. L. Howell (Eds.), Consumers as providers in psychiatric rehabilitation (pp. 45–63). Columbia, MD: International Association of Psychosocial Rehabilitation Services

    Google Scholar 

  • Mowbray, C. T., Moxley, D. P, Thrasher, S. P., Bybee, D., McCrohan, N., Harris, S. & Clover, G. (1996). Consumers as community support providers: Issues created by role innovation. Community Mental Health Journal, 32(1), 47–67

    Article  PubMed  CAS  Google Scholar 

  • New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. (2003). Executive Summary, DHHS, Pub. No. SMA-03–3831. Rockville MD

  • Paulson, R., Herinckx, H. Demmler, J., Clarke, G., Cutler, G. & Birecree, E., (1999). Comparing practice patterns of consumer and non-consumer mental health service providers. Community Mental Health Journal, 35(3), 251–269

    Article  PubMed  CAS  Google Scholar 

  • Pearl, A. (1974). Paraprofessionals and social change. Personnel and Guidance Journal, 53, 264–270

    Google Scholar 

  • Pickett, A. L. (1984) The paraprofessional movement: An update. Social Policy, 14(3), 40– 43

    PubMed  CAS  Google Scholar 

  • Ralph, R. O. (2000). Review of recovery literature: A synthesis of a sample of recovery literature 2000. National Technical Assistance Center for State Mental Health Planning, National Association for State Mental Health Program Directors

  • Rothman, J., & Thomas, E. J. (Eds.), (1994). Intervention research design and development for human service New York: Haworth

    Google Scholar 

  • Rothman J. & Tumblin, A. (1994). Pilot testing and early development of a model of case management intervention. In J. Rothman & E.J. Thomas (Eds.), Intervention research design and development for human service (pp. 215–244). New York: Haworth

    Google Scholar 

  • Sarason, B. R., Sarason, I. G., & Pierce, G. R. (Eds.) (1990). Social support: An interactional view NY: Wiley

    Google Scholar 

  • Salzer, M. S. (1997). Consumer empowerment in mental health organizations. Administration and Policy in Mental Health, 24(5), 425–434

    Article  PubMed  CAS  Google Scholar 

  • Salzer, M. S. (2002). Best practice guidelines for consumer-delivered services. Peoria, IL and Bloomington, IL: Behavioral Health Recovery Management Project, An Initiative of Fahette Companies; Chestnut Health Systems and the University of Chicago Center for Psychiatric Rehabilitation

  • Salzer, M. S., & Shear, S. L. (2002). Identifying consumer-provider benefits in evaluations of consumer-delivered services. Psychiatric Rehabilitation Journal, 25(3), 281–288

    PubMed  Google Scholar 

  • Schiff, A. C. (2004). Recovery and mental illness: Analysis and personal reflections. Psychiatric Rehabilitation Journal, 27(3), 212–218

    Article  PubMed  Google Scholar 

  • Simpson, E. L., & House, A. O. (2005). Involving users in the delivery and evaluation of mental health services: systematic review. BMJ, 325, 1265–1268

    Article  Google Scholar 

  • Solomon, P. (2004). Peer support/ peer provided services underlying processes, benefits, and critical ingredients.Psychiatric Rehabilitation Journal, 27(4), 392–402

    Article  PubMed  Google Scholar 

  • Solomon, P., & Draine, J. (1995). The efficacy of a consumer case management team: 2-year outcomes of a randomized trail. The Journal of Mental Health Administration, 22(2), 135–146

    Article  CAS  Google Scholar 

  • Solomon, M. L., Jonikas, J. A., Cook, J. A. & Kerouac, J. (1998). Positive partnerships: How consumers and nonconsumers can work together as service providers. Second edition Chicago, IL: National Research and Training Center on Psychiatric Disability

    Google Scholar 

  • Steele, K., & Berman, C. (2001). The day the voices stopped: A memoir of madness and hope Basic Books: New York

    Google Scholar 

  • Strauss , A. & Corbin, J. (1990). Basics of Qualitative Research Newbury Park: Sage

    Google Scholar 

  • Torrey, W. C., & Wiyzik, P. (2000). The recovery vision as a service improvement guide for community mental health center providers. Community Mental Health Journal, 36(2), 209–216

    Article  PubMed  CAS  Google Scholar 

  • Torrey, W, C., Rapp, C. A., Van Tosh, L, McNabb, C. R. A., & Ralph, R. O. (2005). Recovery principles and evidence-based practice: Essential ingredients of service improvement. Community Mental Health Journal, 41(1), 91–100

    Article  PubMed  Google Scholar 

  • Vandergang, A. J. (1996). Consumer/survivor participation in the operation of community metal health agencies and programs in metro Toronto: Input or impact? Canadian Journal of Community Mental Health, 15(2), 153–170

    PubMed  CAS  Google Scholar 

  • Zwerling, C., Whitten, P. S., Davis, C. S., & Sprince, N. L. (1997). Occupational injuries among workers with disabilities: The national health interview survey, 1985–1994. JAMA, 278(24), 2163–2167

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was funded, in part, by The New York Community Trust. The authors wish to acknowledge their project partner Howie the Harp Advocacy Center, its Executive Director LaVerne Miller and Research Assistant Jennifer Gulizio. Their outstanding contribution was vital to the achievements of this project.

Author information

Authors and Affiliations

  1. Center for Social Policy and Practice in the Workplace, Columbia University School of Social Work, 1255 Amsterdam Ave., 10027, New York, NY, USA

    Lauren B. Gates & Sheila H. Akabas

Authors
  1. Lauren B. Gates
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sheila H. Akabas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lauren B. Gates.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gates, L.B., Akabas, S.H. Developing Strategies to Integrate Peer Providers into the Staff of Mental Health Agencies. Adm Policy Ment Health 34, 293–306 (2007). https://doi.org/10.1007/s10488-006-0109-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-006-0109-4

Keywords

Search

Navigation