同行支持越来越被认为是世界各地精神卫生服务不可或缺的一部分。然而,大多数关于同行支持的研究来自高收入国家,很少关注不同设置之间的异同,以及它们如何影响实施。精神卫生工作者在将正式的同伴支持纳入法定服务方面可以发挥重要作用,他们对同伴支持的态度可能代表成功实施的障碍或促进者。因此,这项研究调查了精神卫生工作者对一系列高(德国,以色列),中间-(印度),和低收入国家(坦桑尼亚,乌干达)设置。
在乌尔姆和汉堡(德国)进行了六个焦点小组,Butabika(乌干达),达累斯萨拉姆(坦桑尼亚),是舍瓦(以色列),还有Ahmedabad,古吉拉特邦(印度),共有35人参加。使用主题内容分析对成绩单进行分析。
研究中心的参与者对精神卫生保健中的同伴支持表现出总体积极态度,尽管有人对同伴支持的潜在有害影响提出了一些担忧,例如负面的角色建模和向服务用户提供的建议不足。值得注意的是,来自低收入和中等收入国家的精神卫生工作者将同伴支持工作者描述为桥梁建设者,并强调同伴支持的共同利益。精神卫生工作者对同伴支持工作者的角色和角色边界的看法在各个站点之间有所不同。在某些设置中,精神卫生工作者强烈同意角色明确的必要性,而在其他人中,精神卫生工作者表达了不同的观点,有些人更喜欢模糊的角色界限。关于合作,精神卫生工作者将同伴支持工作者描述为支持者和利用者,平等的伙伴或强调需要信任和承诺。
精神卫生工作者对同伴支持工作者的态度总体上是积极的,但它们也因当地情况而异,与同行支持的资源和以前的经验。这影响了他们对同伴支持工作者角色的概念,角色清晰,和合作。这项研究表明,调和对本地适应的需求和维护同伴支持的核心价值是必要的,也是可能的。特别是在全球范围内加速实施以恢复为导向的干预措施,如同伴支持。
Peer support is increasingly acknowledged as an integral part of mental health services around the world. However, most research on peer support comes from high-income countries, with little attention to similarities and differences between different settings and how these affect implementation. Mental health workers have an important role to play in integrating formal peer support into statutory services, and their attitudes toward peer support can represent either a barrier to or facilitator of successful implementation. Thus, this study investigates mental health workers\' attitudes toward peer support across a range of high- (Germany, Israel), middle- (India), and low-income country (Tanzania, Uganda) settings.
Six focus groups were conducted in Ulm and Hamburg (Germany), Butabika (Uganda), Dar es Salaam (Tanzania), Be\'er Sheva (Israel), and Ahmedabad, Gujarat (India) with a total of 35 participants. Transcripts were analyzed using thematic content analysis.
Participants across the study sites demonstrated overall positive attitudes towards peer support in mental health care, although some concerns were raised on potentially harmful effects of peer support such as negative role modelling and giving inadequate advice to service users. Notably, mental health workers from low- and middle-income countries described peer support workers as bridge-builders and emphasized the mutual benefits of peer support. Mental health workers\' views on peer support workers\' roles and role boundaries differed between sites. In some settings, mental health workers strongly agreed on the need for role clarity, whereas in others, mental health workers expressed mixed views, with some preferring blurred role boundaries. Regarding collaboration, mental health workers described peer support workers as supporters and utilizers, equal partners or emphasized a need for trust and commitment.
Mental health workers\' attitudes toward peer support workers were positive overall, but they also varied depending on local context, resources and previous experiences with peer support. This affected their conceptions of peer support workers\' roles, role clarity, and collaboration. This study demonstrated that reconciling the need for local adaptations and safeguarding the core values of peer support is necessary and possible, especially when the implementation of recovery-oriented interventions such as peer support is accelerating worldwide.