Supporting recovery: challenges for in-home psychiatric support workers

Abstract

Purpose – The concept of recovery is well accepted internationally as a guiding vision for mental health services. The purpose of this paper is to highlight the challenges faced by in-home psychiatric support workers in implementing this vision in their work with clients with severe psychiatric disability. Design/methodology/approach – The findings reported here are based on interviews with 27 support workers and ten managers of organisations providing support services. These were collected as part of evaluations of two supported housing programmes carried out between 2010 and 2011. Findings – Challenges faced by support workers coalesced around two areas: first, balancing the need to provide care with the need to promote autonomy and second, developing an effective working relationship while working mainly within a clients’ home. Practical implications – These challenges for support workers highlight tensions within the recovery vision that are not easily resolved. To ensure high quality, recovery-oriented care services are provided, support workers need access to training courses that focus on challenging areas of this work and should be provided with regular professional supervision. Originality/value – Existing literature on support workers has generally focused on the nature of the role and support worker interactions with other health workers. In this paper, the authors highlight difficulties faced by support workers in implementing the vision of recovery in their work. The paper provides important information for policy makers and managers who are designing service delivery systems that aim to promote recovery.

Intentions and experiences of effective practice in mental health specific supported accommodation services: a qualitative interview study

“…In Australia, when support workers and managers of a floating outreach programme were interviewed about their perceptions of the service, joint effort and involvement to avoid deskilling and dependency was highlighted through the theme of balancing the provision of care with the promotion of autonomy. In addition, feeling known and personally understood was also reflected in the author’s analysis of developing an effective working relationship [ 37 ]. Similar to our findings, in the United States of America, qualitative and observational studies with clients in supported accommodation services have noted the importance of stability, security, safety, and a flexible approach to foster a sense of autonomy [ 38 , 39 ].…”

“It’s about Living Like Everyone Else”: Dichotomies of Housing Support in Swedish Mental Health Care

“…HS has emerged as essential for enabling the everyday life and providing non-clinical support to people with SMI who are living independently (Brolin et al, 2018;Shepherd & Meehan, 2013;Shepherd et al, 2014). This population of people is faced with the task of managing their social lives, interacting with others, and establishing their home lives in the context of a community.…”

“…The context of professional work performed in private spaces is largely built on the quality of relations existing between HSWs and users, and creates special circumstances for negotiating own positions, roles, and performing various tasks. HSWs face numerous emotional and bureaucratic challenges (Ericsson & Bengtsson Tops, 2014;Ericsson et al, 2016) involving, among other things, a need to balance duties and relations to clients (Shepherd et al, 2014) while simultaneously negotiating their own position in relation to other mental health care professionals (Shepherd, 2019).…”