Description and evaluation of a serious game intervention to engage low secure service users with serious mental illness in the design and refurbishment of their environment

Abstract

Service user involvement in all levels of healthcare provision is the expectation of UK government policy. Involvement should not only include participation in the planning and delivery of health care but also the exercise of choice and opinions about that care. In practice, however, service user engagement is most often tokenistic, involving post hoc consultation over plans already committed to by services. This paper explores an Occupational Therapy-led initiative to use the Serious Game format to engage low secure service users with serious mental illness in the design, layout and refurbishment of their unit. Among other things how medication was to be dispensed on the new unit was explored by this game and led to significant replanning in response to service user involvement. The game format was found to be a useful tool in facilitating communication between professionals and a traditionally marginalized and powerless client group. It enabled service users to have a voice, it provided a format for that voice to be heard and made possible service-led change in the planning process.

Engaging patients to improve quality of care: a systematic review

“…Of those that evaluated experiences, ten studies reported positive views, while in two studies, patients reported negative experiences and two studies reported both positive and negative experiences (Additional file 3 : Table S1). Of the positive experiences, patients and carers expressed satisfaction with the engagement processes [ 43 , 78 ] were interested in continuing their involvement in the longer term, [ 75 ] felt the experience to be educational, [ 52 ] and felt that participation highlighted issues that would have otherwise been ignored [ 39 , 64 , 75 ]. Positive experiences were linked to feeling empowered and independent as a result of skills development and positive recognition [ 58 , 59 , 63 ].…”

Heard and valued: the development of a model to meaningfully engage marginalized populations in health services planning

“…Some successes in more intense participation came through engagement processes built into interactions between patients and practitioners, particularly in community-based services with recurring interaction with patients [ 28 – 31 ]. In these processes, there were no additional costs to attending an engagement event beyond seeking care and patients could directly benefit from changes to services.…”

“…Most projects, particularly those involving more intense levels of engagement, engaged participants on issues related to a specific health service. Participants were recruited from the service and patients were motivated to participate because they had opportunity to directly impact these services and therefore their own lives [ 21 , 26 , 28 – 32 ].…”

“…After laying this foundation, engagement processes should reinforce trust and safety while empowering participants. Several common strategies were used, including processes that gave participants the power to name and define issues that were important to them [ 20 , 23 , 24 ], explicitly prioritizing and legitimizing lived experiences as a form of evidence [ 22 , 27 ], supporting women to contribute in a variety of ways, and acknowledging their contributions [ 21 , 23 , 25 , 28 ].…”

Embedding Physical Activity in the Heart of the NHS: The Need for a Whole-System Approach

“…Not only has this led to improved patient experiences and reduced aggression towards frontline staff [ 53 ], but also project evaluations report £3 worth of benefits for every £1 spent [ 54 ]. Involving patients directly in the redesign and refurbishment of low-secure mental health units, using a ‘serious gaming’ approach, has also provided valuable insight into the needs of otherwise difficult-to-engage groups and has led to practical service improvements [ 55 ].…”