["Change Agents" Or "Peer Washing": Can Peer Support Workers Contribute To The Transformation Of Psychiatric Institutions?] / "Change Agents" oder "Peer Washing": inwiefern können Peer- und Genesungsbegleiter*innen zur Veränderung von psychiatrischen Einrichtungen beitragen?

OBJECTIVE: Peer support workers (=PSW) are expected to change the culture of a care facility. It is examined whether and how they can implement such a change mandate. METHODS: The material is based on two sub-studies of the ImpPeer-Psy5 study, investigating the implementation of PSW in the German psychiatric care system. Data from 57 problem-centered interviews and two focus groups were analyzed using a thematic analysis. RESULTS: PSW need courage, also as their impulses for change are often insufficiently received. This can lead to the reproduction of exclusion and to the PSWs' adaption to the attitudes of the teams. CONCLUSIONS: To facilitate the implementation of the PSWs' change mandate, power relations and structural discrimination should be reflected, exchange spaces and a culture of critique should be established, and enough time be allowed for the implementation of PSW.

Implementing peer support work in mental health care in Germany: The methodological framework of the collaborative, participatory, mixed-methods study (ImpPeer-Psy5).

BACKGROUND: Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. METHODS: This manuscript presents and discusses the methodological framework of the ImpPeer-Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed-methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. DISCUSSION AND PRACTICAL IMPLICATIONS: The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. PATIENT AND PUBLIC CONTRIBUTION: The research team of the ImpPeer-Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation.