We propose conducting an exploratory policy case study where the case is defined as the integration of formalized/intentional peer support services within clinical services located in hospital, primary care and community settings. Formalized/intentional peer support refers to peer support services (either group or one-to-one) focusing on issues such as education, employment, mental health systems navigation, systemic/individual advocacy, supported housing, food security, internet, transportation, recovery education, and antidiscrimination work. We will examine two sub-cases: peer support in Norway and in Ontario, Canada. These jurisdictions were selected because they are comparable in terms of socioeconomic development, embrace a recovery orientation, and are actively seeking to expand peer support in mental health service delivery, yet differ in important contextual factors, such as the policy climate and levers adopted to support implementation. Our data sources will include key informant interviews, surveys and published academic and grey literature. We will purposively sample the most common approaches to engagement of PSPs in adult mental health settings.
In Ontario, our recruitment strategy will focus on St. Joseph’s Healthcare Hamilton’s (SJHH) inpatient, Assertive Community Treatment Teams (ACTT) and outpatient clinic programs. In Norway, we will identify organizations that offer similar programs, including St. Olav’s Hospital Trondheim. Using a combination of focus groups and individual interviews, we will engage PSPs (6-10 in Canada and 4-6 in Norway), and individuals and families receiving peer support (6-10 in Canada and 4-6 in Norway), 5-10 front line staff (e.g. 2 psychiatrists, nursing, allied health professionals) and supervisors associated with each program1. We will also conduct individual interviews with 2-3 policy makers in each jurisdiction (e.g. in Canada the Ministry of Health and Long-Term Care, the Hamilton Niagara Haldimand Brant Local Health Integration Network) (Table 1). We will tailor the focus group and interview guides to capture the perspectives of each participant type, but will explore common topics including: experience of providing/receiving peer support, barriers and facilitators to effective integration of PSPs46 (e.g. regulatory, funding, payment, organizational policies, team climate, information sharing, peer support and service delivery model) and change management approaches and implementation frameworks adopted. The survey (approx. 30 participants per sub-case) will focus on the influence of team climate on integration and functioning of PSPs.
– Drs. Gillian Mulvale, Karl-Johan Johansen, and co-investigators
Article from Michael G. DeGroote Health Leadership Academy.