Representation through Lived Experience: Expanding Representative Bureaucracy Theory

Abstract

This study draws on the insights of managers in the behavioral health treatment system to explore the value of persons who bring lived experience to their organizational positions. Within these organizations, persons with relevant lived experience occupy various nonclinical and clinical positions. When facilities incorporate workers with lived experience, managers observe increased levels of trust between clients and service providers, an enhanced client-centered perspective among service providers, and higher quality in the services provided. This study may guide managers in considering how (or whether) human service organizations might institutionalize lived experience as a mechanism to help create a representative bureaucracy. PRACTICE POINTS• In the behavioral health treatment system, the use of peer-provided services demonstrates an organization's commitment to engaging with and learning from the experiences of former service recipients.• Employees who have experienced the challenges an organization addresses introduce distinct, relevant knowledge that cannot be replicated through education and training.• Active representation on the basis of lived experience is neither inherent nor automatic and is influenced by institutional and contextual factors.• In the behavioral health treatment system, organizations reduce challenges associated with integrating workers with lived experience by clearly defining roles and responsibilities, education and training, formal supervision and monitoring processes, and policies/rules that outline clear boundaries between persons with lived experience and clients.• If care is taken to develop roles and job descriptions that make thoughtful and appropriate use of workers with lived experience, organizations may improve their capacity to serve their clientele.

Peer Workers in Co-production and Co-creation in Mental Health and Substance Use Services: A Scoping Review

“…Nineteen of the 29 studies were qualitative and reported on outcomes from the perspectives of service users (Bocking et al, 2018 ; Fallin-Bennett et al, 2020 ; Gidugu et al, 2015 ; Taylor et al, 2018 ), mental health professionals (Agrawal et al, 2016 ; Collins et al, 2016 ; White et al, 2017 ), managers (Byrne et al, 2018 ; Merritt et al, 2020 ), caregivers (Yuen et al, 2019 ), and peer workers themselves (Griffiths & Hancock-Johnson, 2017 ). Several studies combined perspectives from some of the involved actors, either as part of case studies (Collins et al, 2019 ; Davies et al, 2014 ) or through interviews with several stakeholders (Barr et al, 2020 ; Brasier et al, 2022 ; Jack et al, 2018 ; Otte et al, 2019 ; Tseris, 2020 ).…”

“…The overall response was that the other participants highly valued peer workers’ involvement. Nevertheless, some studies revealed the fear that peer workers’ recovery process could negatively impact the support provided (Collins et al, 2016 , 2019 ; Ogundipe et al, 2019 ), that risks might arise as a result of peer workers’ lack of training and support (Griffiths & Hancock-Johnson, 2017 ; Merritt et al, 2020 ; Yuen et al, 2019 ), that boundaries between peer workers and service users are blurred (White et al, 2017 ), and that service users need to have opportunities to choose among peer workers as service providers (Ogundipe et al, 2019 ).…”

“…Most studies in this category recognized peer workers’ intermediary positions, which aligned with the description of boundary spanners (Meerkerk & Edelenbos, 2018 ). As such, peer workers were told to facilitate communication between actors lacking access to or trust in one another (Wallace et al, 2018 ) and to be cultural brokers who, in different ways, gain or increase trust in the services or in non-peer providers (Lennox et al, 2021 ; MacLellan et al, 2017 ; Olding et al, 2022 ; Otte et al, 2019 ; Siantz et al, 2018b ); this is because they help open up previously unattainable communication channels between the organization and its clients (Merritt et al, 2020 ), or they transfer the trust they earned from patients to providers and systems that may otherwise be viewed as untrustworthy (Collins et al, 2019 ). Furthermore, peer workers as providers of peer support were often told to be service users’ advocates, increasing their involvement with the services, as well as bridging and helping service users navigate the service systems.…”

A replication of “Representative bureaucracy and the willingness to coproduce”

“…To advance theoretical development, research on symbolic representation would benefit from a deeper understanding of underlying mechanisms related to individual meanings and identities (Merritt et al, 2020; Ospina et al, 2018). The contextual factors that drive uncertainty and citizens' susceptibility to representation remain unclear.…”

Om kollektiv mobilisering – en innledning

“…«Verktøykassen» erfaringskonsulenter er i besittelse av som følge av sin liminale posisjon, kan gjøre dem i stand til å formidle erfaringer og kunnskap mellom ulike aktører, diskurser og kunnskapsformer. Erfaringskonsulenter beskrives videre ofte å ha et nettverk og en sosial kapital som hjelper dem å engasjere forskjellige aktører til å utvikle et sterkt engasjement (Bocking et al, 2018;Chisholm & Petrakis, 2020;Merritt et al, 2020). Det er også vanlig at erfaringskonsulenter har en sterk tilknytning til brukerorganisasjoner (Gillard et al, 2015;Åkerblom et al, 2020).…”