A survey of mental health consumers' and family members' involvement in advocacy

Service user involvement in mental health care: an evolutionary concept analysis

BACKGROUND

The concept of service user involvement is an evolving concept in the mental health-care literature.

OBJECTIVE

This study sought to explore and analyse the concept of service user involvement as used in within the field of mental health care.

METHODOLOGICAL APPROACH

An evolutionary concept analysis was conducted using a literature-based sample extracted from an electronic database search. One hundred and thirty-four papers met the inclusion criteria and were analysed to discover key attributes, antecedents and consequences of service user involvement and to produce a definition of the concept.

FINDINGS

Five key attributes of service user involvement within the context of mental health care were identified: a person-centred approach, informed decision making, advocacy, obtaining service user views and feedback and working in partnership.

DISCUSSION AND CONCLUSIONS

Clarity of the attributes and definition of the concept of service user involvement aims to promote understanding of the concept among key stakeholders including mental health professionals, service users and community and voluntary organizations. The findings of the research have utility in the areas of theory and policy development, research on service user involvement in mental health care and service user involvement in mental health practice. Directions for further research regarding the concept are identified.

Consumer and carer participation in mental health care: the carer's perspective: part 2 - barriers to effective and genuine participation

Family members and significant others provide significant proportions of unpaid care for people experiencing a mental illness. Although the carer role is pivotal to contemporary mental health service delivery, the role of carers and the issues they face have received only scant attention in the literature. This paper presents the second part of the findings of an exploratory, qualitative inquiry, which sought greater understanding of carers' experiences of, and attitudes to opportunities for participation in care and treatment at an individual or systemic level, with particular emphasis on the role of psychiatric nurses in encouraging or discouraging participation. This paper explores the theme of systemic barriers to participation. These findings demonstrate the variable experiences of carers in their opportunities to participate and the important role nurses can assume in supporting carers' increased participation in the mental health care for their relative or significant other.

Consumer and carer participation in mental health care: the carer's perspective: part 1 - the importance of respect and collaboration

The role of family carers in the delivery of mental health services in Australia has become more than an advantage over not having this sort of participation. Increasingly the involvement of non-paid carers (family members and significant others) has been recognised as central to the smooth delivery of care and treatment. Notwithstanding this acknowledgment, there is very little discussion of carer participation in mental health care delivery within the literature. The limited research in this area suggests that carers recognize very little opportunity for genuine participation, even less than is available to consumers. This paper presents part 1 of the findings of an exploratory, qualitative study seeking an in-depth understanding of the attitudes of carers from rural Victoria, Australia toward opportunities for participation with specific emphasis on the role of psychiatric nurses in encouraging or discouraging participation. The themes of respect and communication will be described in this paper. These findings demonstrate the variable experiences of carers in their opportunities to participate and the important role nurses can assume in supporting both carers and consumers through this process.

The participation of mental health service users in Ontario, Canada: a Canadian Application of the Consumer Participation Questionnaire

BACKGROUND

Ontario mental health policy calls for the participation of service users in mental health organizations, but no studies have examined the extent to which this is occurring.

AIMS

This study measures the extent to which service users participate in Ontario, Canada community mental health organizations and measures the attitudes toward service user participation in planning and in employment.

METHODS

Members of the Ontario Federation of Community Mental Health and Addictions Programs were invited to participate in a modified form of the Consumer Participation Questionnaire, created by Kent and Read (1998) for New Zealand.

RESULTS

Participation in Ontario community mental health organizations was present in this order: planning, membership on boards of directors, attendance at staff training, policy, staff hiring, and teaching at staff training. Compared with New Zealand, the prevalence of participation was higher in Ontario, but attitudes toward participation were similar. The role with the highest prevalence of participation, planning, was the same for both locations.

CONCLUSIONS

An updated New Zealand study is called for, as is a more continuous method that includes various voices for measuring participation.

Consumer representation in multi-site HIV, mental health, and substance abuse research: the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study

Funders of HIV, mental health, and substance abuse research and services are increasingly mandating substantial consumer representation in the programmes they support. A review of the literature reveals that despite considerable challenges, consumer representation in HIV, mental health, and substance abuse research and services can be extremely valuable, both for the consumer representatives and the programmes they serve. The consumer representation model of the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study is described. Consumer representatives and principal investigators are interviewed about their experiences working within the model. Their collective comments form the basis of recommendations for practice when employing consumer representation models.

The role of group interest, identity, and stigma in determining mental health policy preferences

Public attitudes toward mental health present an interesting puzzle. While mental health is one aspect of general health and well-being, it receives less support for government spending increases than does health care. One explanation lies with the stigma that is attached to mental illness. This stigma produces more negative attitudes on policy issues related to persons with mental illness such as government spending for mental health. However, group identification, as defined by personal experience or a family member who has experienced a mental illness, may have a strong effect on these attitudes. Using data from the 1996 General Social Survey's module on mental health. I examine this and other hypotheses and find evidence that group identification increases the likelihood of increased support for government spending for mental health. These robust findings exist even in quantitative models, which include politically relevant variables and measure identification with mental illness in two different ways. These findings suggest that mental health is policy for the few because those most supportive of government spending increases are persons who share the common identity of experiencing mental illness.