הערכת יישום פרויקט UPSIDES ("אפסיידס") בישראל: מסקנות לקידום יישום מיטבי של תמיכת עמיתים בשירותי השיקום בבריאות הנפש בישראל

Abstract

Background: Over the last few decades there is an increasingly heavy burden on mental health (MH) in Israel and around the world. Peer providers are a relatively new and contributing service. Peers integrate into the rehabilitation system alongside various professionals, including occupational therapists. When optimally integrated into MH services, peers can support service users' recovery, benefit their own recovery, and promote a recovery and person-centered orientation in MH organizations. However, there are multiple implementation challenges which make peer contribution somewhat questionable. UPSIDES – an international project aims to enhance and scale up implementation of peer support in five countries across Europe, Africa, and Asia. As part of this program, a peer support intervention was developed and implemented in two mental health rehabilitation organizations in Israel. The aim of the study: To examine the implementation process of peer support within UPSIDES project in Israel. Research method: Participatory action research using a qualitative method that focuses on implementation evaluation. Twenty six interested parties participate in 4 focus groups and 6 interviews, following the UPSIDES intervention implementation. A qualitative thematic analysis was performed based on the CFIR framework, using MAXQDA 2020 software. Findings: UPSIDES provided a comprehensive response to implementation of peer support addressing most challenges previously identified. However, 4 challenges emerged: (i) being positioned in a dual role: traditional and peer-designated role in the same organization, (ii) maximizing impact on the organization, (iii) adequate staff training, and (iv) the sustainability of the intervention. Conclusions and implications for practice and policy: The remaining challenges highlight that in order to promote a recovery and person-centered orientation in MH organizations and sustainable peer roles, there is a need for professional training and guidance throughout the implementation processes across all levels of the organization. More specifically if is recommended to encourage direct exposure of teams to peer roles and newly developed governmental policies, fund and enforce designated peer roles, advance peer training and certification processes, alongside education and training for organizations.