Representative Bureaucracy Through Staff With Lived Experience: Peer Coproduction in the Field of Substance Use Disorder Treatment

Abstract

This study extends the representative bureaucracy literature by theorizing and empirically testing how staff sharing lived experience with service users can serve as user representatives in service provision processes (i.e., the peer coproduction mechanism). Using survey data from a representative sample of substance use disorder treatment clinics in the United States, we explore factors associated with descriptive representation (the presence of staff with firsthand experience of a substance use disorder in both frontline treatment and senior positions) and directors’ perceptions of recovering staff’s potential to serve as user representatives in individual care and organizational decision-making processes. Recovering staff accounted for a third of the field’s workforce, but the majority of the clinics did not employ them in senior staff positions. Regression results suggest that organizational leaders’ recognition of recovering staff’s unique representation capacities may facilitate greater descriptive representation and grant meaningful organizational decision-making authority to recovering staff. Multiple research and practice implications are discussed.

Democratising Measurement: or Why Thick Concepts Call for Coproduction

“…Members of the public are typically the ones whose wellbeing is being studied and their perspective on their own wellbeing is clearly of unique significance. In this role people have what is sometimes called 'lived expertise', in the sense that their knowledge of wellbeing comes from navigating daily tasks of life often from the vantage point of their own circumstances such as disability, poverty, or another source of perspective (Park, 2020). This is in contrast to the role of scholarly researchers for whom wellbeing and measurement are objects of technical study undertaken at universities or think tanks.…”

Bureaucratic Representation, Accountability, and Democracy: A Qualitative Study of Indigenous Bureaucrats in Australia and Canada

“…First, an expansion of qualitative approaches and the type of minority bureaucrat population under scrutiny can help add depth to existing empirical studies of representation, which can be viewed as dominated by quantitative studies, many in the United States, of bureaucrats across a somewhat restricted range of functions (Park 2020). By prioritizing qualitative alongside quantitative methods, we can better explore the lived experience of “representative” bureaucrats; the links between passive, active, and symbolic representation; and the causal mechanisms that link, or might link, bureaucratic representation to policy outcomes and impacts.…”

“…We do not seek to deny the importance and utility of quantitative studies. However, adding to them with qualitative research creates substantial opportunities to advance the field by helping to probe and establish the nature of causal processes involved in generating the observed relationships and outcomes (see Headley, Wright, and Meier 2021; Keiser 2010; Kennedy 2013; Park 2020). Given authors are often unable to establish which of several alternative causal factors explain observed outcomes (for example Coleman, Brudney, and Kellough 1998, 734–735; Meier and Nicholson Crotty 2006, 858), the proposal that we should perform larger studies using more refined statistical techniques (Coleman, Brudney, and Kellough 1998, 735; Sowa and Sally 2003) will only take us so far.…”

Theorizing Status Distance: Rethinking the Micro Theories of Representation and Diversity in Public Organizations

“…The second transformation of the theory of RB by the American context was the focus on salient social identities with political relevance. Initially that meant a focus on race (Meier, 1993) and gender (Keiser et al, 2002), but later also on sexual orientation (Thielemann & Stewart, 1996), veteran's status (Gade & Wilkins, 2013), and recently, lived experiences (Park, 2020;Zamboni, 2020), and other factors. This focus meant that RB concerned groups that were generally disadvantaged by the existing political system, giving the theory a heavily normative component (Keiser, 2010).…”