“It was great to break down the walls between patient and provider”: liminality in a co-produced advisory course for psychiatry residents

Agrawal, Sacha; Kalocsai, Csilla; Capponi, Pat; Kidd, Sean A.; Ringsted, Charlotte; Wiljer, David; Soklaridis, Sophie

doi:10.1007/s10459-020-09991-w

Cited by 16 publications

(26 citation statements)

References 56 publications

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“…We describe this theme as Navigating liminal spaces when implementing peer support in mental health systems. Liminality denotes transitional or transformative states, where usual practices and structures have been suspended but where new ones have not yet been established (32), and has been applied in recent literature to explore and describe the complexities involved in transformational change in roles and cultures within mental health systems (33).…”

Section: Resultsmentioning

confidence: 99%

Managing Peer Support Workers in Swedish Mental Health Services – A Leadership Perspective on Implementation and Sustainability

Grim

Bergmark

Argentzell

et al. 2022

Preprint

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Background: Even though it has been demonstrated that peer support contributes to positive outcomes for service users, organizational implementation issues remain. The aim of the current study was to examine an implementation of peer support from the perspective of managers in order to develop knowledge of factors influencing sustainability of this initiative.Methods: Eighteen managers were interviewed in connection with the introduction of peer support in sixteen mental health settings. The interviews were transcribed and analyzed utilizing inductive as well as deductive approaches where, in the latter, a theoretical framework was applied in order to identify critical implementation components at the levels of organization, team and continuous support. Results: The results suggested that managers were predominantly positive in their evaluation of peer support as a recovery-oriented and user-friendly addition to their services, but noted developmental issues regarding role, professional identity, supervision and financing in relation to other traditional personnel. Managers also reflected on the fact that broader commitment at higher levels of the organizational leadership was largely lacking in relation to implementing user involvement in the organization as a whole. The involvement of the user movement, especially with regard to training and supervision helped prepare staff and support peer workers, yet there was some apprehension attached to the critical scrutiny that this ‘outsider’ perspective might imply. Conclusions: The results confirm previously noted uncertainties regarding peer support as an integrated component of mental health systems. While offering clues as to the factors that would further define and integrate peer support, this study also highlights a number of challenges regarding role, identity and connection to the user movement, that need to be considered by managers before assuming that peer support should be implemented with the same approach as other interventions. The findings suggest that the implementation of peer support requires a comprehensive shift in perspectives, power dynamics and culture. Simultaneously, peer support is highlighted as a catalyst for progress towards increasingly recovery-oriented care-giving cultures.

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Section: Resultsmentioning

confidence: 99%

Managing Peer Support Workers in Swedish Mental Health Services – A Leadership Perspective on Implementation and Sustainability

Grim

Bergmark

Argentzell

et al. 2022

Preprint

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“…The final 7 high-quality theoretical papers were published between 2006 and 2020, most (n = 5) within the last two years and were from Europe and Canada (Table 2). Four papers focused on uni-professional student groups: two were undergraduate in medicine (Kline (Hache et al, 2020), and two were postgraduate in medicine (Jha et al, 2015) and psychiatry (Agrawal et al, 2020). Two studies were interprofessional including medicine, speech and language therapy, midwifery, nursing, physiotherapy, occupational therapy, and social work (Anderson et al, 2019;Cooper & Spencer-Dawe, 2006).…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

A theoretical systematic review of patient involvement in health and social care education

Bennett-Weston

Gay

Anderson

2022

Adv in Health Sci Educ

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Patient involvement in health and social care education lacks theoretical underpinning, despite increasing calls for rigour. Theories help explain how learning is advanced and offer guidance for how faculty work with patients who become involved in curriculum delivery. We conducted a systematic review to synthesise how theory shapes our understanding of patient involvement in health and social care education. Three databases were systematically searched. Studies demonstrating explicit and high-quality application of theory to patient involvement in teaching and learning or involvement within a community of health and social care educators, were included. A narrative synthesis was undertaken using Activity Theory as an analytical lens to highlight the multifaceted components of patient involvement in professional education. Seven high-quality, theoretically underpinned studies were included. Four studies applied theory to pedagogy, showing how deep learning from patient involvement occurred. Despite a growing body of studies which attempt to use theory to explain learning, many were descriptive, lacked theoretical quality and were therefore excluded. Three studies applied theory to illuminate the complexity of involving patients in the educational system, showing how patients can be supported and valued in teaching roles. This review highlights that more work is required to identify the mechanisms through which patient involvement enhances learning and, to explore what involvement within the education community means for faculty and patients. Our understandings of patient-educator partnerships for learning could be progressed by further high-quality theory driven studies, which include the patient voice.

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“…During this course, patient partners served as advisors to resident physicians and fostered participants' empathy and reflection. 47 Such examples of coproduced education have improved students' respect, empathy, and compassion for patients. At the same time, students are motivated to challenge structural MHSU stigma while recognizing the role of power imbalances in the doctor-patient relationship in reproducing health inequities.…”

Section: Meaningful Patient Partnershipsmentioning

confidence: 99%

Dismantling Structural Stigma Related to Mental Health and Substance Use: An Educational Framework

et al. 2021

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Stigma related to mental health and substance use (MHSU) is a wellestablished construct that describes how inequitable health outcomes can result from prejudice, discrimination, and marginalization. Although there is a body of literature on educational approaches to reduce stigma, antistigma education for MHSU has primarily focused on stigma at the social, interpersonal/ public, and personal (self-stigma) levels, with little attention to the problem of structural stigma. Structural stigma refers to how inequity is manifested through rules, policies, and procedures embedded within organizations and society at

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“It was great to break down the walls between patient and provider”: liminality in a co-produced advisory course for psychiatry residents

Cited by 16 publications

References 56 publications

Managing Peer Support Workers in Swedish Mental Health Services – A Leadership Perspective on Implementation and Sustainability

Managing Peer Support Workers in Swedish Mental Health Services – A Leadership Perspective on Implementation and Sustainability

A theoretical systematic review of patient involvement in health and social care education

Dismantling Structural Stigma Related to Mental Health and Substance Use: An Educational Framework

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