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.

KEYWORDS:

• Workforce/workplace issues in human service organizations
• organizational and management theory and analysis
• community engagement and advocacy

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.

Notes

¹ Managers’ perceptions were influenced by other roles/people in the organization who have lived experience. The managers themselves did not have relevant lived experience as it related to the current study.

Additional information

Funding

This work was supported by the Indiana University-Purdue University Indianapolis.