Working towards co-production in rehabilitation and recovery services

Adult forensic mental health services provide care and treatment to individuals with complex offending and mental health histories. However, little attention has been paid to the parents of those receiving care within them. This research explored the experiences of parents with an adult son or daughter with mental illness in a medium secure mental health unit. Transcripts from semi-structured interviews were analysed using interpretative phenomenological analysis. This led to the identification of three superordinate themes: 'Something's not right'-onset of mental distress; 'It's a terrible battle'-relating with professionals; and 'A very sad fact of life'-caring with no end in sight were identified which together contained nine subordinate themes. The onset of the mental distress was narrated as overwhelming, frightening, and confusing with experiences of violence. Services were seen as invalidating, and interactions with them characterized as a battle. Poor information and involvement were a common experience. Whilst diagnosis was a relief to some, the ongoing sense of loss and burden were clear. Staying connected and hopes for the future were also described. It is clear from this study that mental health services need to do more to engage and foster trust with parents from the outset and to offer support for this group. If secure services were to view parents as 'forensic carers', this may help improve respect and engagement between services and carers. Services and policymakers should strive to foster high-quality family involvement as part of developing social inclusion.

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“…However, the most effective approach may be for services to enact a coproduction agenda with both service users and carers (Freeman et al . ).…”

Section: Discussionmentioning

confidence: 97%

“…Implementing the 'Triangle of Care' (Worthington et al 2013) across services would also support this ambition as would creating specialist roles or link workers within services to lead this work. However, the most effective approach may be for services to enact a coproduction agenda with both service users and carers (Freeman et al 2016).…”

Section: Discussionmentioning

confidence: 99%

Taking parents seriously: The experiences of parents with a son or daughter in adult medium secure forensic mental health care

Finlay-Carruthers

Davies

Ferguson³

et al. 2018

Int J Mental Health Nurs

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“…Although focus group 3 (predominantly made up of RMN) noted specific tools used for this, the absence of any discussion of these in the other groups may indicate that such approaches are not embedded widely within the team or are only employed by registered staff. Promoting such tools could provide practical ways to support co‐produced/ person‐centred care (Epstein, Fiscella, Lesser & Stange, ; Freeman et al, ) to aid therapeutic engagement. Although not a specific question on the topic guide, the discussion of ‘team‐level formulations’ (Johnstone, ) in groups 1 and 2 suggested deciphering patterns in behaviour to be important for developing staff knowledge and understanding of individual service users (McAllister et al, ).…”

Section: Discussionmentioning

confidence: 99%

Exploring therapeutic engagement with individuals with a diagnosis of personality disorder in acute psychiatric inpatient settings: A nursing team perspective

Acford

Davies

2019

Int J Mental Health Nurs

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Individuals with a diagnosis of personality disorder (PD) face negative attitudes and are often deemed harder to care for than individuals with other diagnoses. To improve care and engagement with services, it is essential to understand the ways general psychiatric nursing staff approach this client group. This research aims to examine the ways inpatient psychiatric nursing staff therapeutically engage with individuals with a diagnosis of PD. Focus groups were conducted with Registered Mental Health Nurses (n = 7) and Health Care Assistants (formally known as nursing assistants; n = 12) who care for individuals with a diagnosis of PD in a general psychiatric inpatient setting. A thematic analysis indicated six themes: the right frame of mind, knowing the service user, knowing when to engage, service user input, a unified approach, and structured admissions. The findings highlight what non‐PD specialist inpatient nursing staff do in order to engage therapeutically with this group of service users and areas that require improvement. Supporting good practice could improve staff confidence when caring for this client group, lower stigma around the diagnosis, and promote a more positive experience of care for individuals with a diagnosis of PD who are using general inpatient mental health services.

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Co-producing Psychiatric Education with Service User Educators: a Collective Autobiographical Case Study of the Meaning, Ethics, and Importance of Payment

et al. 2019

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Objective Co-production involves service providers and service users collaborating to design and deliver services together and is gaining attention as a means to improve provision of care. Aiming to extend this model to an educational context, the authors assembled a diverse group to develop co-produced education for psychiatry residents and medical students at the University of Toronto over several years. The authors describe the dynamics involved in co-producing psychiatric education as experienced in their work. Methods A collaborative autobiographical case study approach provides a snapshot of the collective experiences of working to write a manuscript about paying service users for their contributions to co-produced education. Data were collected from two inperson meetings, personal communications, emails, and online comments to capture the fullest possible range of perspectives from the group about payment. Results The juxtaposition of the vision for an inclusive process against the budgetary constraints that the authors faced led them to reflect deeply on the many meanings of paying service user educators for their contributions to academic initiatives. These reflections revealed that payment had implications at personal, organizational, and social levels. Conclusion Paying mental health service user educators for their contributions is an ethical imperative for the authors. However, unless payment is accompanied by other forms of demonstrating respect, it aligns with organizational structures and practices, and it is connected to a larger goal of achieving social justice, the role of service users as legitimate knowers and educators and ultimately their impact on learners will be limited.

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Working towards co-production in rehabilitation and recovery services

Abstract: Working towards Co-production in Rehabilitation and Recovery Services.

Cited by 4 publications

References 9 publications

Taking parents seriously: The experiences of parents with a son or daughter in adult medium secure forensic mental health care

Taking parents seriously: The experiences of parents with a son or daughter in adult medium secure forensic mental health care

Exploring therapeutic engagement with individuals with a diagnosis of personality disorder in acute psychiatric inpatient settings: A nursing team perspective

Co-producing Psychiatric Education with Service User Educators: a Collective Autobiographical Case Study of the Meaning, Ethics, and Importance of Payment

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