scholarly journals User Involvement in Mental Health Services: A Case of Power over Discourse

2014 ◽  
Vol 19 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Lydia Lewis
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
User Involvement ◽  
Service Development ◽  
Service Users ◽  
Policy Initiative ◽  
Implementation Gap ◽  
Emergent Feature ◽  
And Control

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.

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
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Mental Health Services ◽  
Health Services ◽  
User Involvement ◽  
Politics Of Recognition ◽  
Implementation Gap ◽  
The Core ◽  
Mental Health Service User ◽  
The Uk

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.

Service users' views regarding user involvement in mental health services: A qualitative study

2018 ◽  
Vol 32 (5) ◽  
pp. 695-701 ◽  
Author(s):  
Minna Laitila ◽  
Jalmiina Nummelin ◽  
Tiina Kortteisto ◽  
Anneli Pitkänen
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Qualitative Study ◽  
Health Services ◽  
User Involvement ◽  
Service Users

scholarly journals Encouraging user involvement in mental health services

2005 ◽  
Vol 11 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Lynda Tait ◽  
Helen Lester
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Good Practice ◽  
User Involvement ◽  
Evidence Base ◽  
Service Development ◽  
Mental Health Service User

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.

scholarly journals Remote care for mental health: qualitative study with service users, carers and staff during the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049210
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Jennie Parker ◽  
Janet Willars ◽  
David Scott ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Well Being ◽  
Comparison Method ◽  
Service Users ◽  
Qualitative Interview Study ◽  
Remote Care

ObjectivesTo explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic.DesignQualitative interview study, codesigned with mental health service users and carers.MethodsWe conducted semistructured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method.SettingNational Health Service (NHS) secondary mental health services in England between June and August 2020.ParticipantsOf 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic.ResultsExperiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments and identification of deteriorating mental well-being. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost.ConclusionsThough remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.

scholarly journals Demystifying the pathway of assessment and treatment for bipolar disorder – utilising co-production and algorithms to personalise the approach

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S150-S150
Author(s):  
Jessica Nicholls-Mindlin ◽  
Digby Quested ◽  
Matthew Taylor ◽  
Lauren Fuzi ◽  
David Gee
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Public Involvement ◽  
Psychological Intervention ◽  
Patient And Public Involvement ◽  
Service Development ◽  
Post Discharge ◽  
Nice Guideline

AimsTo develop an evidence based, patient centred treatment pathway for people experiencing symptoms of bipolar disorder (BD), modifiable to include local resources.MethodThis project was developed in line with current approaches to service development such as coproduction, with patient and public involvement (PPI) and enhancing personalisation of treatment in medicine. As part of a local initiative, a multi-disciplinary team was brought together to understand and analyse the current local pathway for those affected by BD. It was found that the approach to assessment and management was not consistent between locality teams. Two experts by experience who have a diagnosis of BD were invited to become involved with the development of the pathway. Meetings were set up to enable coproduction and elicit information from those with the diagnosis. The responses provided insight into the effectiveness of different approaches used nationally to inform the methods and resources that are most helpful and appropriate to comprehensively support those with the illness.NICE guideline evidence was used to create two algorithms to streamline the care of those with BD in both primary and secondary care. These algorithms include pharmacological, psychological and social approaches. It also considers the junctions at which referrals should be made and the criteria on which decisions are based.ResultOne algorithm was designed for use in primary care and will be distributed to local GPs to clarify the initial steps for assessment and management of BD and the criteria for referral. A second decision tree will be made available to all doctors working in mental health services with detailed medication options, when they are appropriate and whether additional psychological intervention should be considered e.g. post-discharge groups. Other specialist options such as Early Intervention for Psychosis and Perinatal Mental Health Services were also included. An information pack was created to be offered to all those with a diagnosis or possible diagnosis of BD. This contains useful resources such as skills and exercises that patients may find of benefit, external resources and websites regarding additional support and further information on BD, its nature and management.ConclusionThe approach and resources collated here will help to streamline the management of those with bipolar disorder whilst also ensuring a more consistent approach. The involvement of experts by experience and the incorporation of NICE guidelines ensures a well-rounded and comprehensive set of documents that will be helpful to both clinicians and patients.

Research watch: what really helps recovery in relation to severe mental health difficulties?

2020 ◽  
Vol 24 (1) ◽  
pp. 6-12
Author(s):  
Sue Holttum
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Design Methodology ◽  
Support Service ◽  
Health Condition ◽  
Service Users ◽  
Content Type ◽  
Inpatient Settings ◽  
Mental Health Difficulties

Purpose The purpose of this paper is to examine three recent papers on mental health services and how they support recovery following a diagnosis of a severe mental health condition. Design/methodology/approach A search was carried out for recent papers on mental health and recovery. The author selected three papers that seemed to advance understanding of not only whether, but also how recovery of a meaningful life may be best supported in mental health services. Findings One paper suggested how staff were able to support service users’ personal goals and focus on recovery in acute inpatient settings, and what got in the way. The author suggests practical ways to address the barriers. A second paper reported the testing of a new model for supporting staff in primary and secondary care to work together so that service users with a diagnosis of bipolar or schizophrenia were better supported to work towards valued goals. A third paper reviewed 40 studies of how people can experience positive change after a first diagnosis of psychosis, and how change happened. Originality/value By studying the issues in detail, all three papers show how improved support for recovery and inclusion can be implemented against the backdrop of many years of service shortcomings.

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