scholarly journals Politics of Recognition: What Can a Human Rights Perspective Contribute to Understanding Users' Experiences of Involvement in Mental Health Services?

2009 ◽  
Vol 8 (2) ◽  
pp. 257-274 ◽  
Author(s):  
Lydia Lewis

In the UK, participation in decision-making is increasingly being viewed as a right for users of mental health services. Yet research repeatedly finds a policy implementation gap in this area. Drawing on a localised, qualitative study involving three mental health service user/community groups, this article frames this issue in terms of a ‘politics of recognition’. It demonstrates how whilst government user involvement policies officially attempt to recognise users and their voices, they simultaneously reconstitute failures of recognition in terms of status subordination and a disqualified identity for service users, thereby obstructing participatory parity and amounting to a dereliction of the core principles underlying human rights.

2014 ◽  
Vol 19 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Lydia Lewis

Public participation in planning and implementing health care has become a government mandate in many states. In UK mental health services, this ‘user involvement’ policy dates back nearly three decades and has now become enshrined in policy. However, an implementation gap in terms of achieving meaningful involvement and influence for service users persists. This paper aims to illuminate some of the political discursive processes through which this gap emerges and to educe implications for the policy initiative and for effective approaches to service user involvement. It presents findings from a qualitative, localised UK-based study of user involvement in mental health services, conducted from a critical discourse analytic perspective, according to one emergent feature - power over discourse. Three themes relating to this discursive regulation are discussed: the rules of the game, the rules of engagement and agenda-setting. The article shows how although the policy initiative was providing opportunities for discursive contestation in local arenas surrounding mental health service development, these were pre-dominantly characterized by containment and control and by silences. Consequently, the discursive processes of user involvement worked to nullify its potentially transformative influence and to further marginalize women service users and other groups. Implications for the development of user involvement in service commissioning are provided.


2005 ◽  
Vol 11 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Lynda Tait ◽  
Helen Lester

This article summarises the current research evidence base on user involvement in mental health services from both policy and practical perspectives. We begin by examining the many meanings of the term ‘mental health service user’ and the policy imperatives for user involvement, to provide a context for later examples of good practice. We then discuss what is meant by ‘involvement’ and the reasons why user involvement is particularly important in mental health services. Finally, we describe some of the traditional barriers to involvement and a number of examples of positive practice across a range of different aspects of mental health service development and delivery.


2003 ◽  
Vol 27 (09) ◽  
pp. 346-348
Author(s):  
Chris Simpson ◽  
Prasanna De Silva

The increase in older people in the UK will increase the need for mental health services to run efficient, high-quality services. Multi-disciplinary team assessments, although not new, provide a method of increasing the capacity to see referrals. Two similar systems of multi-disciplinary team assessments from North Yorkshire are reported with evidence of improvement in quality.


2012 ◽  
Vol 36 (2) ◽  
pp. 45-50 ◽  
Author(s):  
Geoff Dickens ◽  
Judy Weleminsky ◽  
Yetunde Onifade ◽  
Philip Sugarman

Aims and methodMental Health Recovery Star is a multifaceted 10-item outcomes measure and key-working tool that has been widely adopted by service providers in the UK. We aimed to explore its factorial validity, internal consistency and responsiveness. Recovery Star readings were conducted twice with 203 working-age adults with moderate to severe mental health problems attending a range of mental health services, and a third time with 113 of these individuals.ResultsMental Health Recovery Star had high internal consistency and appeared to measure an underlying recovery-oriented construct. Results supported a valid two-factor structure which explained 48% of variance in Recovery Star ratings data. Two Recovery Star items (‘relationships’ and ‘addictive behaviour’) did not load onto either factor. There was good statistically significant item responsiveness, and no obvious item redundancy. Data for a small number of variables were not normally distributed and the implications of this are discussed.Clinical implicationsRecovery Star has been received enthusiastically by both mental health service providers and service users. This study provides further evidence for its adoption in recovery-focused mental health services and indicates that items relating to addictive behaviour, responsibilities and work could be further developed in future.


2013 ◽  
Vol 202 (s54) ◽  
pp. s41-s44 ◽  
Author(s):  
Clare Lamb ◽  
Margaret Murphy

SummaryThis discussion paper outlines our personal views for debate on some of the complexities inherent in the crucial task of improving mental health services for young people in the UK.


2016 ◽  
Vol 40 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Paul Stallard ◽  
Michelle Maguire ◽  
Justin Daddow ◽  
Rosie Shepperd ◽  
Mike Foster ◽  
...  

Aims and methodTo review the deaths of children and young people who took their own life. We conducted a retrospective analysis of serious incident reports from a National Health Service trust and reviews by the child death overview panels of the local safeguarding children boards.ResultsWe identified 23 deaths, with annual rates varying considerably between local authorities and over time. Over half of the children (n = 13, 56%) were not known to specialist child and adolescent mental health services, with 11 having no contact with any agency at the time of their death. Hanging was the most common method (n = 20, 87%) and of these, half (n =11, 55%) were low-level hangings.Clinical implicationsTraining is required to improve awareness, recognition and the assessment of children at risk of taking their own life. Specialist child mental health services should directly assess plans or attempts at hanging and offer advice about the seriousness of attempting this. National data (by age) on children and young people who take their own life should be routinely published to inform clinical and preventive services.


1997 ◽  
Vol 2 (2) ◽  
pp. 86-93 ◽  
Author(s):  
David Mechanic

People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various financial and organizational approaches to reduce fragmentation and increase effectiveness, including development of stronger public mental health authorities, use of financial incentives to change professional and institutional behavior, requirements to allocate savings from hospital closures to community systems of care, and introduction of mental health managed care on a broad scale. These approaches have potential but also significant problems and there is often a large gap between theory and implementation. These US developments are discussed with attention to the implications for mental health services in the UK.


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