Perceived barriers and facilitators to implementation of peer support in Veterans Health Administration Primary Care-Mental Health Integration settings
Peer support is increasingly recognized as consistent with the goals of integrated primary care and is being implemented in primary care settings as a patient-centered approach that increases patient activation and access to care. Within the Veterans Health Administration (VHA), peer support special...
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Published in | Psychological services Vol. 16; no. 3; p. 433 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
01.08.2019
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Abstract | Peer support is increasingly recognized as consistent with the goals of integrated primary care and is being implemented in primary care settings as a patient-centered approach that increases patient activation and access to care. Within the Veterans Health Administration (VHA), peer support specialists (PSSs) have traditionally worked in specialty mental health settings and only recently started working in Primary Care-Mental Health Integration (PC-MHI) settings. Prior research has identified implementation challenges, such as role confusion, when integrating peer support into new settings. In this qualitative descriptive study, we conducted semistructured interviews on perceived barriers and facilitators to implementing peer support in PC-MHI with 25 key stakeholders (7 PSSs, 6 PSS supervisors, 6 PC-MHI providers, and 6 primary care providers). We used conventional content analysis to code responses within four a priori implementation categories: barriers, initial facilitators, long-term facilitators, and leadership support. Perceived barriers included poor program functioning, inadequate administrative support, role confusion, and negative stakeholder attitudes. Key perceived facilitators of initializing and maintaining peer support were similar; administrative support was emphasized followed by program functioning and team cohesion. Stakeholder buy-in and access/visibility were perceived to facilitate initial implementation, whereas evidence of success was believed to facilitate maintenance. Stakeholder buy-in and administrative support were considered key elements of leadership support. Results were consistent with prior research from specialty mental health settings, but identified unique considerations for PC-MHI settings, particularly clarifying the PSS role based on local PC-MHI needs, obtaining buy-in, and facilitating integration of PSSs into the primary care team. (PsycINFO Database Record (c) 2019 APA, all rights reserved). |
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AbstractList | Peer support is increasingly recognized as consistent with the goals of integrated primary care and is being implemented in primary care settings as a patient-centered approach that increases patient activation and access to care. Within the Veterans Health Administration (VHA), peer support specialists (PSSs) have traditionally worked in specialty mental health settings and only recently started working in Primary Care-Mental Health Integration (PC-MHI) settings. Prior research has identified implementation challenges, such as role confusion, when integrating peer support into new settings. In this qualitative descriptive study, we conducted semistructured interviews on perceived barriers and facilitators to implementing peer support in PC-MHI with 25 key stakeholders (7 PSSs, 6 PSS supervisors, 6 PC-MHI providers, and 6 primary care providers). We used conventional content analysis to code responses within four a priori implementation categories: barriers, initial facilitators, long-term facilitators, and leadership support. Perceived barriers included poor program functioning, inadequate administrative support, role confusion, and negative stakeholder attitudes. Key perceived facilitators of initializing and maintaining peer support were similar; administrative support was emphasized followed by program functioning and team cohesion. Stakeholder buy-in and access/visibility were perceived to facilitate initial implementation, whereas evidence of success was believed to facilitate maintenance. Stakeholder buy-in and administrative support were considered key elements of leadership support. Results were consistent with prior research from specialty mental health settings, but identified unique considerations for PC-MHI settings, particularly clarifying the PSS role based on local PC-MHI needs, obtaining buy-in, and facilitating integration of PSSs into the primary care team. (PsycINFO Database Record (c) 2019 APA, all rights reserved). |
Author | Shepardson, Robyn L Johnson, Emily M Possemato, Kyle Arigo, Danielle Funderburk, Jennifer S |
Author_xml | – sequence: 1 givenname: Robyn L orcidid: 0000-0001-6954-5920 surname: Shepardson fullname: Shepardson, Robyn L organization: Center for Integrated Healthcare, Syracuse VA Medical Center – sequence: 2 givenname: Emily M surname: Johnson fullname: Johnson, Emily M organization: Center for Integrated Healthcare, Syracuse VA Medical Center – sequence: 3 givenname: Kyle surname: Possemato fullname: Possemato, Kyle organization: Center for Integrated Healthcare, Syracuse VA Medical Center – sequence: 4 givenname: Danielle surname: Arigo fullname: Arigo, Danielle organization: Department of Psychology, The University of Scranton – sequence: 5 givenname: Jennifer S surname: Funderburk fullname: Funderburk, Jennifer S organization: Center for Integrated Healthcare, Syracuse VA Medical Center |
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SubjectTerms | Attitude of Health Personnel Counseling Delivery of Health Care, Integrated Humans Mental Disorders - psychology Mental Disorders - therapy Mental Health Mental Health Services Peer Group Primary Health Care Social Support United States United States Department of Veterans Affairs Veterans Health |
Title | Perceived barriers and facilitators to implementation of peer support in Veterans Health Administration Primary Care-Mental Health Integration settings |
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