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Motivations of Persons with Psychiatric Disabilities to Work in Mental Health Peer Services: A Qualitative Study Using Self-Determination Theory

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Abstract

Introduction Individuals with psychiatric disabilities have low rates of employment and occupational rehabilitation success. Mental health peer services are a new occupational modality that opened a promising occupational path: persons with serious mental illnesses employed to provide support to others with psychiatric conditions. However challenges to successful peer work exist. Work motivation is central to understanding and supporting peer workers, yet little is known about sources of motivation to work as mental health peer providers. The aim of this study was to identify what drives individuals to mental health peer work using self determination theory (SDT). Methods Motivations of 31 mental health peer workers were explored as part of a larger study. A theory driven approach was employed to emerging qualitative data using SDT concepts: external motivation and internally regulated motivations derived from basic needs (autonomy, competence, relatedness). Results External motivations included generic occupational goals and getting away from negative work experiences. Internal motivations corresponded with SDT basic needs: autonomy met-needs was reflected in having freedom to disclose and finding that work accords with personal values; competence met-needs was reflected in using personal experience as a resource to help others; and relatedness met-needs were reflected in having opportunity to connect intimately and reciprocate with consumers. Conclusion This study identified external and internal motivations of persons with psychiatric disabilities to work as peer providers—a novel occupation in mental health. Employing personal experience and enabling peer contact emerge as major motivational tenets of mental health peer work. According to SDT instrumental occupational goals are considered more external than satisfaction of basic psychological needs. The study demonstrates the applicability of SDT in the design of autonomy supported environments to promote work engagement and sustenance of mental health peer providers.

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References

  1. Cook JA. Employment barriers for persons with psychiatric disabilities, update of a report for the President’s Commission. Psychiatr Serv. 2006;57:1391–405.

    Article  PubMed  Google Scholar 

  2. Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein D. Cost of lost productive time among U.S. workers with depression. JAMA. 2003;289(23):3135–44.

    Article  PubMed  Google Scholar 

  3. Henry AD, Banks S, Clark R. Mobility Limitations Negatively Impact Work Outcomes among Medicaid Enrollees with Disabilities J Occup Rehabil. 2007;17(3):355–69.

    Google Scholar 

  4. MacDonald-Wilson K, Rogers ES, Anthony WA. Unique issues in assessing work function among individuals with psychiatric disabilities. J Occup Rehabil. 2001;11(3):217–32.

    Article  CAS  PubMed  Google Scholar 

  5. Rosenheck RA, Leslie D, Keefe R, McEvoy J, Swartz M, Perkins D, et al. Barriers to employment for people with schizophrenia. Am J Psychiatry. 2006;163:411–7.

    Article  PubMed  Google Scholar 

  6. Salkever DS, Karakus MC, Slade EP, Harding CM, Hough RL, Rosenheck RA, et al. Measures and predictors of community based employment and earnings of persons with schizophrenia in a multisite study. Psychiatr Serv. 2007;58:315–24.

    Article  PubMed  Google Scholar 

  7. Waghorn G, Chant D. Receiving Treatment, Labor Force Activity, and Work Performance Among People with Psychiatric Disorders: Results from a Population Survey. J Occup Rehabil. 2011;21:547–58.

    Article  PubMed  Google Scholar 

  8. Becker DR, Drake RE. A working life for people with severe mental illness. New York: Oxford University Press; 2003.

    Book  Google Scholar 

  9. Bond GR, Kukla M. Is job tenure brief in Individual Placement and Support (IPS) employment programs? Psychiatr Serv. 2011;62:950–3.

    Article  PubMed  Google Scholar 

  10. McQuilken M, Zahniser JH, Novak J, Starks RD, Olmos A, Bond GR. The work project survey: consumer perspectives on work. J Vocat Rehabil. 2003;18:59–68.

    Google Scholar 

  11. Dutta A, Gervey R, Chan F, Chou ChCh, Ditchman N. Vocational rehabilitation services and employment outcomes for people with disabilities: a United States study. J Occup Rehabil. 2008;18:326–34.

    Article  PubMed  Google Scholar 

  12. Rogers ES, Anthony WA, Toole J, Brown MA. Vocational outcomes following psychosocial rehabilitation: a longitudinal study of three programs. J Vocat Rehabil. 1991;1:21–9.

    Google Scholar 

  13. Shean GD. Evidence-based psychosocial practices and recovery from schizophrenia. Psychiatry. 2009;72(4):307–20.

    PubMed  Google Scholar 

  14. Rivera JJ, Sullivan AM, Valenti SS. Adding consumer-providers to intensive case management: does it improve outcome? Psychiatr Serv. 2007;58(6):802–9.

    Article  PubMed  Google Scholar 

  15. Salzer MS. Consumer empowerment in mental health organizations: concept, benefits, and impediments. Adm Policy Ment Health. 1997;24(5):425–34. doi:10.1007/BF02042724.

    Article  CAS  PubMed  Google Scholar 

  16. Solomon P. Peer support/peer provided services underlying processes, benefits and critical ingredients. Psychiatr Rehabil J. 2004;27(4):392–401. doi:10.2975/27.2004.392.401.

    Article  PubMed  Google Scholar 

  17. Davidson L, Chinman M, Kloos B, et al. Peer support among individuals with severe mental illness: a review of the evidence. Clin Psychol Sci Pract. 1999;6:165–87.

    Article  Google Scholar 

  18. Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990’s. Psychosoc Rehabil J. 1993;16(4):11–23.

    Article  Google Scholar 

  19. Davidson L, O’Connell M, Tondora J, et al. The top ten concerns about recovery encountered in mental health system transformation. Psychiatr Serv. 2006;57:640–5.

    Article  PubMed  Google Scholar 

  20. DeSisto M, Harding CM, McCormick RV, Ashikaga T, Brooks GW. The maine and Vermont three-decade studies of serious mental illness: I. matched comparison of cross sectional outcome. Br J Psychiatry. 1995;167:331–8.

    Article  CAS  PubMed  Google Scholar 

  21. New Freedom Commission on Mental Health. Achieving the promise: Transforming mental health care in America. Final report (DHHS Pub. No. SMA-03-3831). Rockville, MD: Substance Abuse and Mental Health Services Administration (2003). Retrieved from http://store.samhsa.gov/product/ SMA03-3831.

  22. Power AK. Paving the road to mental health recovery. Psychiatry. 2010;73(2):114–7. doi:10.1521/psyc.2010.73.2.114.

    PubMed  Google Scholar 

  23. Williams CC, Tufford L. Professional competencies for promoting recovery in mental illness. Psychiatry. 2012;75(2):190–201. doi:10.1521/psyc.2012.75.2.190.

    PubMed  Google Scholar 

  24. Mowbray CT, Moxley DP, Collins ME. Consumers as mental health providers: first-person accounts of benefits and limitations. J Behav Health Serv Res. 1998;25(4):397–411. doi:10.1007/BF02287510.

    Article  CAS  PubMed  Google Scholar 

  25. Salzer MS, Shear SL. Identifying consumer provider benefits in evaluations of consumer-delivered services. Psychiatr Rehabil J. 2002;25(3):281–8.

    Article  PubMed  Google Scholar 

  26. Ratzlaff S, McDiarmid D, Marty D, Rapp C. The Kansas consumer as provider program: measuring the effects of a supported education initiative. Psychiatr Rehabil J. 2006;29(3):174–82. doi:10.2975/29.2006.174.182.

    Article  PubMed  Google Scholar 

  27. Cook JA, Copeland ME, Jonikas JA, Hamilton MM, Razzano LA, Grey DD, et al. Results of a randomized controlled trial of mental illness self-management using Wellness Recovery Action Planning. Schizophr Bull. 2011;1–11. doi:10.1093/schbul/sbr012.

  28. Corrigan PW. Impact of consumer-operated services on empowerment and recovery of people with psychiatric disabilities. Psychiatr Serv. 2006;57(10):1493–6.

    Article  PubMed  Google Scholar 

  29. Lucksted A, McNulty K, Brayboy L, Forbes C. Initial evaluation of the Peer-to-Peer Program. Psychiatr Serv. 2009;60(2):250–3.

    Article  PubMed  Google Scholar 

  30. Pickett SA, Diehl SM, Steigman PJ, Parter JD, Fox A, Shipley P, Grey DD, Cook JA. Consumer empowerment and self-advocacy outcomes in a randomized study of peer-led education. Community Ment Health J. 2012;48:420–30. doi:10.1007/s10597-012-9507-0.

    Article  PubMed  Google Scholar 

  31. Repper J, Carter T. A review of the literature on peer support in mental health services. J Ment Health. 2011;20(4):392–411.

    Article  PubMed  Google Scholar 

  32. Resnick SG, Rosenheck RA. Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment. Psychiatr Serv. 2008;59(11):1307–14.

    Article  PubMed  Google Scholar 

  33. van Gestel-Timmermans H, Brouwers EPM, van Assen MALM, van Nieuwenhuizen C. Effects of a peer-run course on recovery from serious mental illness: a randomized controlled trial. Psychiatr Serv. 2012;63:54–60.

    PubMed  Google Scholar 

  34. Hutchinson DS, Anthony WA, Ashcroft L, et al. The personal and vocational impact of training and employing people with psychiatric disabilities as providers. Psychiatr Rehabil J. 2006;29(3):205–14. doi:10.2975/29.2006.205.213.

    Article  PubMed  Google Scholar 

  35. Salzer MS, Katz J, Kidwell B, Federici M, Ward-Colasante C. Pennsylvania certified peer specialist initiative: training, employment, and work satisfaction outcomes. Psychiatr Rehabil J. 2009;32(4):301–5. doi:10.2975/32.4.2009.301.305.

    Article  PubMed  Google Scholar 

  36. Moran GS, Russinova Z, Gidugu V, Yim JY, Sprauge C. Benefits and mechanisms of peer providers with mental illnesses. Qual Health Res. 2012;22:304–19. First published on 7 Sept 2011. doi:10.1177/1049732311420578.

    Google Scholar 

  37. Moran GS, Russinova Z, Gidugu V, Gagne C. Challenges experienced by paid peer providers in mental health recovery: a qualitative study. Community Ment Health J. 2012. First published on 2 Nov 2012. doi:10.1007/s10597-012-9541-y.

  38. Mancini MA, Lawson HA. Facilitating positive emotional labor in peer-providers of mental health services. Adm Soc Work. 2009;33(1):3–22. doi:10.1080/03643100802508619.

    Article  Google Scholar 

  39. Carlson LS, Rapp CA, McDiarmid D. Hiring consumer-providers: barriers and alternative solutions. Community Ment Health J. 2001;37(3):199–213.

    Article  CAS  PubMed  Google Scholar 

  40. Chinman M, Shoai R, Cohen A. Using organizational change strategies to guide peer support technician implementation in the Veterans Administration. Psychiatr Rehabil J. 2010;33(4):269–77.

    Article  PubMed  Google Scholar 

  41. Bond GR, Campbell K, Becker DR. A Test of the Occupational Matching Hypothesis for Rehabilitation Clients with Severe Mental Illness. J Occup Rehabil. 2012. Published online March 20012; doi:10.1007/s10926-012-9388-7.

  42. Goldstrom ID, Campbell J, Rogers JA, et al. National estimates for mental health mutual support groups, self-help organizations, and consumer-operated services. Adm Policy Ment Health Ment Health Serv Res. 2006;33(1):92–103. doi:10.1007/s10488-005-0019-x.

    Article  Google Scholar 

  43. Segal SP, Hardiman ER, Hodges JQ. Characteristics of new clients at self-help and community mental health agencies in geographic proximity. Psychiatr Serv. 2002;53(9):1145–52.

    Article  PubMed  Google Scholar 

  44. Singer Y. The consumer experience in transitioning to service provider. MA thesis, University of Haifa, Isreal; 2010 [Unpublished manuscript]

  45. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.

    Article  CAS  PubMed  Google Scholar 

  46. Gagne M, Deci EL. Self-determination theory and work motivation. J Org Behav. 2005;26:331–62.

    Article  Google Scholar 

  47. Deci EL, Ryan RM. The “what” and “why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inq. 2000;11(4):227–68.

    Article  Google Scholar 

  48. Deci EL, Ryan RM. Facilitating optimal motivation and psychological well-being across life’s domains. Can Psychol. 2008;49:14–23.

    Article  Google Scholar 

  49. Mancini AD. Self-determination theory: a framework for the recovery paradigm. Adv Psychiatr Treat. 2008;14:358–65.

    Article  Google Scholar 

  50. Moran G, Russinova Z, Stepas K. Toward understanding the impact of occupational characteristics on the recovery and growth processes of peer-providers. Psychiatr Rehabil J. 2012;35(5):376–80.

    Article  PubMed  Google Scholar 

  51. MacFarlane A, O’Reilly-de Brún M. Using a theory-driven conceptual framework. Qual Health Res. 2012;22(5):607–18.

    Article  PubMed  Google Scholar 

  52. Walker D, Myrick F. Grounded theory: an exploration of process and procedure. Qual Health Res. 2006;16(4):547–59.

    Article  PubMed  Google Scholar 

  53. Patton MQ. Qualitative evaluation and research methods. Newbury Park: Sage Publications; 1990.

    Google Scholar 

  54. Ellison ML, Russinova Z, MacDonald-Wilson KL, Lyass A. Patterns and correlates of workplace disclosure among professionals and managers with psychiatric conditions. J Vocat Rehabil. 2003;18(1):3–13.

    Google Scholar 

  55. Onken SJ, Craig CM, Ridgway P, Ralph RO, Cook JA. An analysis of the definitions and elements of recovery: a review of the literature. Psychiatr Rehabil J. 2007;31(1):9–22. doi:10.2975/29.2006.174.182.

    Article  PubMed  Google Scholar 

  56. Brown LD, Shepherd MD, Merkle EC, Wituk SA, Meissen G. Understanding how participation in a consumer-run organization relates to recovery. Am J Community Psychol. 2008;42:167–78.

    Article  PubMed  Google Scholar 

  57. Resnick SG, Rosenheck RA. Recovery and positive psychology: parallel themes and potential synergies. Psychiatr Serv. 2006;57(1):120–2.

    Article  PubMed  Google Scholar 

  58. Moran GS, Nemec P. What positive psychology can contribute to psychiatric rehabilitation. Psychiatr Rehabil J. (under revision).

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Acknowledgments

We thank Philippe Bloch for his feedback on this paper. We acknowledge support by The Dudley Allen Sargent Research Fund (DASRF), Sargent College Alumni Association, Boston University, June 2009.

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Authors and Affiliations

  1. Department of Community Mental Health, University of Haifa, Haifa, Israel

    Galia Sharon Moran

  2. Center for Psychiatric Rehabilitation, Boston University, Boston, USA

    Zlatka Russinova & Catherine Sprague

  3. Biola University, La Mirada, CA, USA

    Jung Yeon Yim

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  1. Galia Sharon Moran
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  2. Zlatka Russinova
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  3. Jung Yeon Yim
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  4. Catherine Sprague
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Correspondence to Galia Sharon Moran.

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Moran, G.S., Russinova, Z., Yim, J.Y. et al. Motivations of Persons with Psychiatric Disabilities to Work in Mental Health Peer Services: A Qualitative Study Using Self-Determination Theory. J Occup Rehabil 24, 32–41 (2014). https://doi.org/10.1007/s10926-013-9440-2

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