Carers and co-production: enabling expertise through experience?

Abstract

PurposeTo provide a brief overview of the literature to date which has focussed on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. DesignThe paper presents key outcomes from studies which have explicitly attempted to introduce coproduced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. FindingsInformal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision-making. This issue is considered alongside new policy recommendations which advocate the development of coproduced services and care. Research LimitationsDespite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical Implications

Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder

“…Our review (Dickens, Hallett, et al, ) also revealed an absence of intervention studies which were explicitly informed by or developed by individuals with BPD‐related expertise‐by‐experience. Despite growing recognition of the need for co‐production of mental health services (Bradley, ), the involvement of service users in research is less well‐documented and there is considerable scope to develop approaches that are informed by an expert by experience perspective. For example, Pinfold et al () consider that co‐production can provide a healthy challenge to traditional research hierarchies as it addresses inequalities in power and control within research projects.…”

A text on which the ink never dries: dialogical practices for care and treatment planning

“…() call for greater flexibility, openness and shared working in care planning. Bradley () argues for a more radical approach involving both service users and carers as active agents and in which professionals relinquish power and control in favour of a more facilitative role.…”

Samproduksjon med pårørende til personer med ROP-lidelser

“…I praksis får en rekke pårørende sentrale oppgaver knyttet til disse pasientene. Likevel viser forskningen at mange av dem ikke opplever at de blir integrert i tjenestetilbudet eller ivaretatt på annen måte (Bradley, 2015;Cree et al, 2015;Rowe, 2012). Tilvarende erfaringer har også norske pårørende som ønsker samarbeid med helsetjenesten.…”

“…Det at omsorgsforpliktelser får store konsekvenser for de pårørende, er heller ikke et saernorsk fenomen. Bradley (2015) konkluderer med at årsakene til dette i stor grad er at de pårørende ikke får tilstrekkelig informasjon og dermed kan medføre økt press på velferdstjenestene. Det er da et paradoks at pårørende avlaster offentlige helse-og velferdstjenester, samtidig som de samfunnsøkonomiske kostnadene for denne avlastningen kan bli høye.…”