Keys to unlocking service provider engagement in constrained co-production partnerships

2020 ◽  
pp. 147675032092586
Author(s):  
Tone Larsen ◽  
Jan E Karlsen ◽  
Hildegunn Sagvaag

The article reports on research conducted in a public, specialised mental health and substance abuse service unit in Norway. The inquiry followed an action research framework, with patients, leaders and staff as co-researchers. Power sharing within such constrained institutions suggests that service providers risk engaging in paternalistic or avoidance approaches. Despite the inherent challenges of attempting a participative approach on an equal footing, facilitating service co-production may be served by mediation and support. Here, developing meeting spaces for dialogue between patients, staff and leaders appears vital. We argue that focussing on service providers’ own professional development may be benefiting to co-production. We propose steps to unlock the potential of genuine co-production partnerships in constrained organisational settings when staff and leaders have no prior experience involving patients systematically in service development.

2017 ◽  
Author(s):  
Martin J Downing Jr ◽  
Dominique Brown ◽  
Jeffrey Steen ◽  
Ellen Benoit

BACKGROUND Childhood sexual abuse (CSA) remains a critical public health issue among black and Latino men who have sex with men (MSM), as it is associated with multiple negative outcomes including substance misuse, poor mental health, revictimization, and high-risk sexual behavior. Most CSA research with MSM relies on quantitative assessment that often precludes consideration of cultural variations in how formative sexual experiences are understood and is based on inconsistent or overly restrictive definitions of abuse, and therefore may fail to detect certain abusive experiences (eg, those involving female perpetrators), which can have harmful health consequences if they remain unrecognized. OBJECTIVE The objective of this study is to overcome existing limitations in the literature by drawing on perspectives of black and Latino MSM and men who have sex with men and women (MSMW), as well as relevant service providers to better understand the role of, and the need to include, sexual abuse histories (eg, CSA) in treatment and counseling settings, with the long-term goal of improving assessment and health outcomes. METHODS We will conduct mixed-methods interviews, framed by an intersectionality approach, with 80 black and Latino men (40 MSM and 40 MSMW) in New York City (NYC), exploring appraisals of their formative sexual experiences, including those described as consensual but meeting criteria for CSA. We will also interview 30 local service providers representing substance abuse treatment, mental health care, and HIV prevention and outreach. RESULTS The study was launched in May 2017. CONCLUSIONS This formative research will inform testable approaches to assessing and incorporating sexual abuse history into substance abuse treatment and other health and mental health services used by men with such histories.


2005 ◽  
Vol 35 (3) ◽  
pp. 575-591 ◽  
Author(s):  
Carol S. North ◽  
David E. Pollio ◽  
Brian Perron ◽  
Karin M. Eyrich ◽  
Edward L. Spitznagel

This study aims to advance understanding of service provision to the homeless population through investigation of the effects of organizational characteristics. A longitudinal study of homelessness obtained structured psychiatric interview data from 400 participants and these individuals' service use and organizational data from 23 organizations over the next 12 months. Substance abuse service use was associated with organizational funding diversity, professionalism, and focus of services on substance abuse service provision. Other mental health service use was associated with small organizational size, professionalism, and simplicity of organizational funding diversity. Shelter service use was associated with complexity of services and small organizational size and inversely related to professionalism of staff. Results suggest relevance of organizational characteristics to understanding service access and use, controlling for individual need factors. Only by examining interactions among individual and organizational characteristics across sectors of care can the complexity of service provision to this multifaceted population be approached.


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