Dr. Sunny Aslam writes a brief report in Psychiatric Services about working alongside mental health peer support employees, based on feedback he obtained from an American Association of Community Psychiatrists e-list. “Nonpeer staff have raised a number of concerns about working with peer staff who are currently receiving treatment from them,” writes Aslam.
Some of the concerns expressed, writes Aslam, include “discomfort in regard to treating fellow state employees; a sense that some peer workers take advantage of their status and do not show up for appointments because they have no fear of consequences; concern about peers sharing confidential information with others who are not authorized to receive such information; concern about not encouraging patients to move on to the ‘real world’ outside the clinic; and concern about a conflict of interest, such as a therapist’s being asked by a frequently suicidal peer worker to have his time sheet signed for hours he had not worked.”
On the topic of being the treating psychiatrist for a peer employee at the same agency, Aslam reports that one respondent said, “I cannot imagine this conversation occurring in any other area of medicine. A cardiologist not treating his partner? Until conversations like this end, the problem we have is stigma, pure and simple. Our own stigma toward the illnesses we treat.” However, Aslam quotes another respondent noting that, “There is much ethical commentary… about treating someone with whom you have another relationship… It can impair your objectivity, and if anything goes wrong, it can be emotionally devastating. This is not an issue of stigma, but one of setting up the best situation for competent care.”
Case Studies in Public-Sector Leadership: How to Help Peer Workers Succeed (Aslam, Sunny P. Psychiatric Services. August 1, 2014; doi: 10.1176/appi.ps.201400098)