Exploring ‘person-centredness’: user perspectives on a model of social psychiatry

Abstract

This paper explores service users' experiences of a 'person-centred' mental health service. We describe the development of a model of social psychiatry that places the emphasis on the experiences of the person within social and political contexts. This establishes the foundations of a 'person-centred' approach, the values of which are described briefly. The results of interviews with 20 people are presented, in which their experiences of the service are explored in detail. These interviews reveal the struggle that lies at the heart of the professional-service user dialectic, which relates to issues of institutional power, roles and responsibility, and which places professional staff in conflict with the very notion of 'person-centredness'. No matter how 'person-centred' a mental health service may strive to be, there remain serious obstacles to the full realization of this approach. Despite this critique, there were many things that were valued by those who used the service. More detailed qualitative studies are required to explicate the complex relationships and paradoxes that emerged.

Comparing patients’ perspectives of “good care” in Dutch outpatient psychiatric services with academic perspectives of patient-centred care

“…The desire of adults with ADHD for more accessible and continuous care, which includes treatments not typically offered for ADHD, have also been described in the UK in a study on patients' experiences of impairment, service provision and clinical management (Matheson et al, 2013). The importance, as well as the potential problems, of a health professional acting professionally and demonstrating empathy as a person is also described by a study of Eliacin et al (2015) on the patients' understanding of shared decision making in mental health setting and Williams et al (1999) on the user perspectives on person-centeredness in social psychiatry.…”

“…This is striking as the core idea of PCC is that the patient should be placed at the centre of healthcare provision (Robinson et al, 2008). To the best of our knowledge, only two qualitative articles have been published about the perspectives of mental health patients on PCC (Corring & Cook, 1999;Williams et al, 1999). Although articles have been published on perspectives of mental health patients on good care, this is not yet linked to PCC (Johansson & Eklund, 2003).…”

Trust, choice and power in mental health

“…The ideological conflict between the patient in the sick role and patient empowerment is evident when different stakeholders are interviewed (73). Setting up patient-led services and patient-centred services to try to overcome this power imbalance is not necessarily successful at achieving that aim, as new power imbalances can emerge (72,71). Studies on patient empowerment suggest that practical steps have been introduced at a managerial and planning level, but this is harder to implement at an individual care level, despite some evidence that patients feel it improves their care (63).…”

Blurred roles and permeable boundaries: the experience of multidisciplinary working in community mental health

“…The decrease in formal role demarcations between staff and clients in mental health initiatives has met with some approval from clients (e.g. Williams et al . 1999 ), where increased friendliness and a decrease in formality are appreciated.…”