Abstract
This qualitative study explored peer provider experiences working in newly integrated mental health and primary care pilot programs within a large public mental health system. Nineteen peer providers participated in semistructured interviews that focused on experiences delivering care within integrated teams. Interviews were analyzed using constant comparative methods informed by grounded theory. Findings were organized into three themes that speak to variation in the definition and function of peers; lack of clarity in the peer role; and relating to other providers. Integrated settings need ongoing support to ensure clarity in the peer role and an inclusive work environment.
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Allen, J., Radke, A. Q., & Parks, J. (Eds.). (2010). Consumer involvement with state mental health authorities. Alexandria: National Association of Consumer/Survivor Mental Health Administrators and National Association of State Mental Health Program Directors.
Barnett, M. L., Gonzalez, A., Miranda, J., Chavira, D. A., & Lau, A. S. (2018). Mobilizing community health workers to address mental health disparities for underserved populations: A systematic review. Administration and Policy in Mental Health, 45(2), 195–211. https://doi.org/10.1007/s10488-017-0815-0.
Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. Thousand Oaks: Sage.
Cabassa, L. J., Camacho, D., Vélez-Grau, C. M., & Stefancic, A. (2017). Peer-based health interventions for people with serious mental illness: A systematic literature review. Journal of Psychiatric Research, 84, 80–89. https://doi.org/10.1016/j.jpsychires.2016.09.021.
California Association of Social Rehabilitation Agencies. (2014). Meaningful roles for peer providers in integrated healthcare: A guide. Retrieved from http://www.casra.org/docs/peer_provider_toolkit.pdf.
Carlson, L. S., Rapp, C. A., & McDiarmid, D. (2001). Hiring consumer-providers: Barriers and alternative solutions. Community Mental Health Journal, 37, 199–213.
Center for Substance Abuse Treatment. (2009). What are peer recovery support services? (DHHS Publication No. SMA 09-4454). Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
Chinman, M., Daniels, K., Smith, J., McCarthy, S., Medoff, D., Peeples, A., et al. (2017). Provision of peer specialist services in VA patient aligned care teams: Protocol for testing a cluster randomized implementation trial. Implementation Science, 12(1), 57.
Colton, C., & Manderscheid, R. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease, 3(2), A42.
County of Los Angeles Department of Mental Health. (2013). Summary of findings: Peer specialist training & core competency committee and age-specific work groups. Retrieved from http://file.lacounty.gov/SDSInter/dmh/194804_PeerSpecialistTraining&CoreCompetencyFindings.pdf.
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, 443–450. https://doi.org/10.1093/schbul/sbj043.
Druss, B. G., Zhao, L., von Esenwein, S. A., Bona, J. R., Fricks, L., Jenkins-Tucker, S., et al. (2010). The health and recovery peer (HARP) program: A peer-led intervention to improve medical self-management for persons with serious mental illness. Schizophrenia Research, 118, 264–270. https://doi.org/10.1016/j.schres.2010.01.026.
Druss, B. G., Zhao, L., Von Esenwein, S., Morrato, E. H., & Marcus, S. C. (2011). Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative US survey. Medical Care, 49, 599–604.
Fraser, D. (2000). QSR NVivo NUD*IST Vivo reference guide. Melbourne: QSR International.
Gates, L. B., & Akabas, S. H. (2007). Developing strategies to integrate peer providers into the staff of mental health agencies. Administration and Policy in Mental Health and Mental Health Services Research, 34(3), 293–306.
Gilmer, T. P., Henwood, B. F., Goode, M., Sarkin, A. J., & Innes-Gomberg, D. (2016). Implementation of integrated health homes and health outcomes for persons with serious mental illness in Los Angeles County. Psychiatric Services, 67(10), 1062–1067.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gruyter.
Goldberg, R. W., Dickerson, F., Lucksted, A., Brown, C. H., Weber, E., Tenhula, W. N., et al. (2013). Living well: An intervention to improve self-management of medical illness for individuals with serious mental illness. Psychiatric Services, 64, 51–57. https://doi.org/10.1176/appi.ps.201200034.
Harvey, G., & Kitson, A. (2015). Implementing evidence-based practice in healthcare: A facilitation guide. London: Routledge.
Henwood, B., Siantz, E., Hrouda, D., Innes-Gomberg, D., & Gilmer, T. (2017). Integrated primary care within assertive community treatment. Psychiatric Services. https://doi.org/10.1176/appi.ps.201700009.
Janssen, E. M., McGinty, E. E., Azrin, S. T., Juliano-Bult, D., & Daumit, G. L. (2015). Review of the evidence: Prevalence of medical conditions in the United States population with serious mental illness. General Hospital Psychiatry, 37(3), 199–222.
Kelly, E., Duan, L., Cohen, H., Kiger, H., Pancake, L., & Brekke, J. (2017). Integrating behavioral healthcare for individuals with serious mental illness: A randomized controlled trial of a peer health navigator intervention. Schizophrenia Research, 182, 135–141.
Kelly, E., Fulginiti, A., Pahwa, R., Tallen, L., Duan, L., & Brekke, J. S. (2014). A pilot test of a peer navigator intervention for improving the health of individuals with serious mental illness. Community Mental Health Journal, 50(4), 435–446. https://doi.org/10.1007/s10597-013-9616-4.
Kilbourne, A. M., Greenwald, D. E., Bauer, M. S., Charns, M. P., & Yano, E. M. (2012). Mental health provider perspectives regarding integrated medical care for patients with serious mental illness. Administration and Policy in Mental Health and Mental Health Services Research, 39(6), 448–457. https://doi.org/10.1007/s10488-011-0365-9.
Kuhn, W., Bellinger, J., Stevens-Manser, S., & Kaufman, L. (2015). Integration of peer specialists working in mental health service settings. Community Mental Health Journal, 51(4), 453–458.
Mancini, M. A. (2018). An exploration of factors that effect the implementation of peer support services in community mental health settings. Community Mental Health Journal, 54(2), 127–137.
SAMHSA-HRSA Center for Integrated Health Solutions. (2016). Peer providers. Retrieved from http://www.integration.samhsa.gov/workforce/peer-providers.
Siantz, E., Henwood, B., & Gilmer, T. (2016). Implementation of peer providers in integrated mental health and primary care settings. Journal of the Society for Social Work and Research, 7(2), 231–246.
Swarbrick, M. A. (2013). Wellness-oriented peer approaches: A key ingredient for integrated care. Psychiatric Services, 64, 723–726. https://doi.org/10.1176/appi.ps.201300144.
Swarbrick, M., Gill, K. J., & Pratt, C. W. (2016). Impact of peer delivered wellness coaching. Psychiatric Rehabilitation Journal, 39(3), 234–238. https://doi.org/10.1037/prj0000187.
Swarbrick, M., Tunner, T. P., Miller, D. W., Werner, P., & Tiegreen, W. W. (2016). Promoting health and wellness through peer-delivered services: Three innovative state examples. Psychiatric Rehabilitation Journal, 39(3), 204–210. https://doi.org/10.1037/prj0000205.
Willms, D. G., Best, J. A., Taylor, D. W., Gilbert, J. R., Wilson, D. M. C., Lindsay, E. A., et al. (1990). A systematic approach for using qualitative methods in primary prevention research. Medical Anthropology Quarterly, 4, 391–409. https://doi.org/10.1525/maq.1990.4.4.02a00020.
Funding
This research was funded by Ruth L. Kirschstein National Research Service Award TL1 National Institutes of Health, National Center for Research Resources, National Center for Advancing Translational Sciences, Southern California Clinical and Translational Science Institute, TL1 for Predoctoral Clinical and Translational Training Award (TL1TR000132).
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Siantz, E., Henwood, B. & Baezcondi-Garbanati, L. From Physical Wellness to Cultural Brokering: Unpacking the Roles of Peer Providers in Integrated Health Care Settings. Community Ment Health J 54, 1127–1135 (2018). https://doi.org/10.1007/s10597-018-0320-2
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DOI: https://doi.org/10.1007/s10597-018-0320-2