Using Organizational Change Strategies to Guide Peer Support Technician Implementation in the Veterans Administration

RAND Corporation, Health Pittsburgh VA Healthcare System, VISN 4 MIRECC, Pittsburgh, PA 15213-2665, USA.
Psychiatric Rehabilitation Journal (Impact Factor: 1.16). 01/2010; 33(4):269-77. DOI: 10.2975/33.4.2010.269.277
Source: PubMed

ABSTRACT The Veterans Administration (VA) mental health system is in the process of hiring "Peer Support Technicians" or PSTs-individuals in recovery from serious mental illnesses hired as clinical team members. The purpose of this article is to demonstrate an implementation process that has potential to improve the deployment of the Peer Support Technicians to existing clinical teams within the VA.
As part of a larger randomized trial called PEers Enhancing Recovery (PEER), research staff collaboratively planned the deployment of PSTs with three case management teams serving those with serious mental illnesses. Clinical staff received significant opportunity to participate in defining the PST role. PEER staff took extensive notes during planning meetings about the discussions held and decisions made about the PST role.
PEER and clinical staff discussed and came to a consensus on several elements that comprise the PST job including goals for employing PSTs, desired characteristics of PSTs, job duties, training to be provided to PSTs, PST access to medical records, supervision, boundaries, confidentiality, how PSTs are to discuss their mental illness with veterans, and a sick leave policy.
It is critical to solicit and use input from team providers and leaders when establishing PST services. This approach using input and solicitation can be a model to implement a wide range of clinical interventions in which existing providers and teams will be asked to do something new.


Available from: Matthew Chinman, May 27, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: New peer worker roles are being introduced into mental health services internationally. This paper addresses a lack of research exploring issues of risk in relation to the role. In-depth interviews were carried out with 91 peer workers, service users, staff and managers. A grounded analysis revealed protective practice in minimising risk to peer worker well-being that restricted the sharing of lived experience, and a lack of insight into how peer workers might be involved in formal risk management. Alternatively, analysis revealed potential new understandings of risk management based on the distinctive, experiential knowledge that peer workers brought to the role.
    Community Mental Health Journal 02/2015; 51(4). DOI:10.1007/s10597-015-9843-y · 1.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A wide variety of peer worker roles is being introduced into mental health services internationally. Empirical insight into whether conditions supporting role introduction are common across organisational contexts is lacking. A qualitative, comparative case study compared the introduction of peer workers employed in the statutory sector, voluntary sector and in organisational partnerships. We found good practice across contexts in structural issues including recruitment and training, but differences in expectations of the peer worker role in different organisational cultures. Issues of professionalism and practice boundaries were important everywhere but could be understood very differently, sometimes eroding the distinctiveness of the role.
    Administration and Policy in Mental Health and Mental Health Services Research 10/2014; DOI:10.1007/s10488-014-0603-z · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Considering international diversity in the implementation of mental health peer support and an increasing research interest in peer support work (PSW), this review focuses on priorities in current research and practice. With grassroots in informal services for people with mental health problems, peer support has been strengthened by the recovery paradigm in mental health policy, and there are steps towards integration in statutory services.
    Current opinion in psychiatry 05/2014; DOI:10.1097/YCO.0000000000000074 · 3.55 Impact Factor