IN THE SYSTEM BUT NOT OF THE SYSTEM: UNDERSTANDING THE ROLE AND EXPERIENCES OF MENTAL HEALTH PEER SPECIALISTS

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Date

2023-08

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[Bloomington, Ind.]: Indiana University

Abstract

Certified peer specialists are mental health professionals who provide non-clinical mental health services to individuals in the community who may be struggling with mental health difficulties. They focus on providing support, hope, and the goal of recovery and do so by drawing upon their own lived experiences with mental illness or, to use non-psychiatric terms, distress, difficulties in living, and extreme states. The case of certified peer specialists allows for an investigation into how peer specialists carry out and experience their work and the implications of their unique approach. Specifically, I consider how peer specialists resist biomedicalization by emphasizing and prioritizing nonmedical, social environmental factors in the etiology and “treatment” of mental health problems. They identify trauma as a key contributor to individuals’ experiences of distress and push back against psychiatric labeling, which may contribute to stigma. Further, the professionalization of peer specialists lends insight into how new professions operate to seek and establish legitimacy, autonomy, and credibility. They must resist stigmatizing attitudes and uncertainty about the profession’s status to legitimize their expert knowledge from lived experience as lay professionals. Finally, peer specialists must engage in emotion work in their everyday work and must cope with their emotions through social support and personal coping strategies. Due to the mutuality, or even power differential, of peer support, what is considered appropriate emotion work for peer specialists may look different than what is appropriate for other professions, namely the ability to openly experience emotions with those receiving support. Using a combination of in-depth interviews with peer specialists, viii participant observation fieldwork at a peer-run nonprofit organization, and a survey of peer specialists across the United States, I investigate how peer specialists operate to demedicalize mental illness, legitimize their profession, and navigate emotions and boundaries at work. This research has meaningful theoretical and practical implications and contributes to a major gap in the sociological literature on peer support, professions, and resistance to biomedicalization.

Description

Thesis (Ph.D.) - Indiana University, Department of Sociology, 2023

Keywords

medical sociology, peer support, mental health, professions, emotion work

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Doctoral Dissertation