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McPhee J, Warner T, Cruwys T, Happell B, Scholz B. 'They don't really know why they're here' mental health professionals' perspectives of consumer representatives. Int J Ment Health Nurs 2023; 32:819-828. [PMID: 36727283 DOI: 10.1111/inm.13124] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
There are several barriers to meaningful, non-tokenistic consumer representation in mental health, including stigma and negative attitudes towards consumers. The aim of this study was to examine mental health professionals' perspectives about collaborating with consumer representatives. Semi-structured interviews were conducted with 11 mental health professionals across Australia. Informed by the social identity framework, the findings are discussed in relation to the themes of (1) the need for greater clarity about the roles of consumer representatives, (2) perceptions about whether consumer representatives are held to equal professional standards, (3) understandings of consumers' place in organizational hierarchies, (4) facilitating more meaningful collaboration between consumer representatives and non-consumer health professionals and (5) the blurring of these identities when mental health professionals have lived experience. Findings suggest that the social identities of mental health consumer representatives (along with their organizational roles) are often unclear and need development within healthcare organizations. Leaders can provide guidance on group boundaries to enable effective collaboration. The implications for healthcare organizations and policy include the provision of clear frameworks for collaborative mental healthcare and clear roles, terminology and responsibilities for mental health consumer representatives.
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Affiliation(s)
- Jody McPhee
- School of Medicine and Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Terri Warner
- School of Medicine and Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia.,ACT Mental Health Consumer Network, Canberra, Australian Capital Territory, Australia
| | - Tegan Cruwys
- School of Medicine and Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Brenda Happell
- Faculty of Health, Southern Cross University, Gold Coast, Queensland, Australia.,School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Brett Scholz
- School of Medicine and Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
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2
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Happell B, Gordon S, Sharrock J, Donovan AO, Kenny N, Warner T. There is something about oppression: Allies' perspectives on challenges in relationships with experts by experience. Int J Ment Health Nurs 2023; 32:744-754. [PMID: 36645058 DOI: 10.1111/inm.13117] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 01/17/2023]
Abstract
The genuine and meaningful involvement of Experts by Experience in the education of health professionals has consistently demonstrated positive attitudinal change in students. These changes are essential if policy goals for recovery-oriented services and service user participation in mental health services are to be realized. To date academic roles for Experts by Experience have often relied on the support of allies. Despite the important role allies play, research investigating their experiences is limited. The aim of this research was to explore allies' views on supporting implementation of the academic positions for Experts by Experience. A qualitative exploratory study was undertaken involving in-depth interviews with 16 allies. Data were analysed thematically. Challenges that can exist between allies and Experts by Experience was one theme identified from the data. Allies described occasional difficulties in their relationships with Experts by Experience where they felt they were perceived as representative of members of their broader profession with whom Experts by Experience had negative experiences. The perspectives of allies are presented in four subthemes: relationships imbedded in history; consequences of interpersonal stigma; supportive, protective or paternalistic?; and the passion remains, which describes allies' ongoing commitment to supporting Expert by Experience involvement. Understanding the challenges can assist allies to respond appropriately in a non-judgemental and supportive manner. Trauma informed practice may provide a useful framework to address conflicts and facilitate more positive relationships between allies and Experts by Experience. These positive relationships are essential to maximize the positive benefits of Experts by Experience on future clinicians.
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Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia.,Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Julie Sharrock
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Aine O' Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Nuala Kenny
- Health Service Executive Bantry, Cork, Ireland.,Expert by Experience, School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Terri Warner
- ANU Medical School, Australian National University, Acton, Australian Capital Territory, Australia.,ACT Mental Health Consumer Network, Canberra, Australian Capital Territory, Australia
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3
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Happell B, Gordon S, Sharrock J, O'Donovan A, Warner T. 'What's she doing here?' Overcoming barriers to the implementation of Expert by Experience positions in academia. Aust Occup Ther J 2022; 69:689-702. [PMID: 35959799 PMCID: PMC10087197 DOI: 10.1111/1440-1630.12832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Experts by Experience involvement in the education of health professionals has gained momentum as an important strategy in ensuring quality, person-centred education. Despite being a requirement for occupational therapy programs in Australia and internationally, involvement is variable and limited. Barriers to the implementation of academic roles have been identified, including negative attitudes of colleagues, systemic barriers, and insufficient evidence of their value. Mental health academics who do not identify as having lived experience (referred to as allies) have provided crucial support for Experts by Experience. Understanding their perspectives on implementation barriers and how they can be addressed is crucial to facilitating a broader level of meaningful involvement. METHODS A qualitative exploratory research project was conducted, involving in-depth interviews with mental health academic allies (n = 16) from Australia, Ireland, and New Zealand. Participants were from the disciplines of nursing, occupational therapy, social work, and psychiatry. Data were analysed thematically. FINDINGS Two main themes were identified from the data analysis process: convincing colleagues and dealing with university barriers. Participants described varying attitudes from colleagues towards Experts by Experience, with many not understanding or appreciating their contribution to education and student outcomes. At the university level, reluctance to embrace innovation and funding and other resource shortages presented impediments to the implementation of Expert by Experience roles. Participants described using creative measures to overcome institutional barriers and encourage greater acceptance of such roles by colleagues. CONCLUSION This research describes how allies experienced and overcame barriers they faced when supporting the implementation of academic positions for Experts by Experience. Allies have an important role to play in overcoming systemic barriers, and the approaches they have taken to achieve this may be an important source of learning for others with similar aspirations.
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Affiliation(s)
- Brenda Happell
- Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia.,School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, Wellington, New Zealand
| | - Julie Sharrock
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Aine O'Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Terri Warner
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.,ACT Mental Health Consumer Network, Canberra, Australian Capital Territory, Australia
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Happell B, Sharrock J, Warner T, O'Donovan A, Hurley E, Gordon S. Changing 'the world for the better': motivations of mental health academics for supporting expert by experience roles in mental health education. J Ment Health 2022:1-8. [PMID: 35766312 DOI: 10.1080/09638237.2022.2091759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Despite demonstrating positive outcomes in education, academic positions for Experts by Experience in mental health have not been widely implemented. To date positions have been driven by individual champions (allies). Their motivation for this support has not yet been researched. AIMS To deepen understanding of motivations of mental health academics who have championed and supported implementation of EBE positions. METHODS A Qualitative exploratory, study was undertaken involving in-depth individual interviews with 16 academics with experience of actively supporting the implementation of Expert by Experience positions in academia. Data were analysed independently by two researchers using a structured thematic framework. RESULTS Motivations commonly arose from allies' own experiences of working with or exposure to Experts by Experience. Other motivating factors included: belief in the value of specific knowledge and expertise Experts by Experience contributed to mental health education; and, identifying the essential role Experts by Experience play in meeting policy expectations, and the broader philosophy of the university. CONCLUSIONS The motivations identified by allies in this study have implications for Expert by Experience roles. Deeper understanding of motivations to support these roles is essential to arguing for their value, and ultimately producing positive outcomes in the education of health professionals.
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Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, and Hunter Institute of Medical Research, and Priority Centre for Health Behaviour, University of Newcastle, University Drive, Callaghan, Australia.,School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Julie Sharrock
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, Australia
| | - Terri Warner
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, Australia
| | - Aine O'Donovan
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Emma Hurley
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Sarah Gordon
- Master of Culture, Health and Medicine (Advanced), Research Assistant, School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, Australia
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Happell B, O'Donovan A, Sharrock J, Warner T, Gordon S. They are a different breed aren't they? Exploring how experts by experience influence students through mental health education. Int J Ment Health Nurs 2021; 30 Suppl 1:1354-1365. [PMID: 34021530 DOI: 10.1111/inm.12881] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 12/23/2022]
Abstract
Experts by Experience (EBE) in mental health are increasingly becoming involved in the education of health professionals. In response, research findings suggest positive attitudinal change towards people who experience mental distress and enhanced appreciation of recovery and person-centred approaches to practice. However, this growing body of evidence has not resulted in the broad adoption of these roles in academia. The perspectives of academics instrumental in implementing academic positions for EBE (referred to as allies) have not yet been articulated. Acknowledging this gap, the aim of this research was to explore experiences of allies involved in implementing EBE positions in academia regarding the impact of EBE led education on students. Qualitative exploratory methods were used involving in-depth interviews with allies. Data were analysed thematically. Participants observed significant positive impacts on students, as evidenced through four themes: contextualized learning, enhancing reflection, feedback from the clinical field, and students' own lived experience. The fifth sub-theme, Challenging experiences were observed to potentially detract from the student experience in some instances. Overall, participants were very supportive of EBE involvement and were confident this approach produced more person-centred and recovery-oriented clinicians, with the skills, knowledge and attitudes needed to work as practitioners. These findings support previous research and suggest positive implications for clinical practice and for students with their own mental health challenges.
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Affiliation(s)
- Brenda Happell
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, Hunter Institute of Medical Research, Priority Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Cluster for Resilience and Well-being, CQUniversity, Callaghan, New South Wales, Australia
| | - Aine O'Donovan
- School of Nursing and Midwifery, ENGAGE: Interdisciplinary Clinical Mental health Research Network, University College Cork, Cork, Ireland
| | - Julie Sharrock
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Terri Warner
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.,ACT Mental Health Consumer Network, Canberra, Australian Capital Territory, Australia
| | - Sarah Gordon
- Department of Psychological Medicine, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
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