The autonomy of professionals and the involvement of patients and families

Knowing What to Do and Being Able to Do It: Influences on Parent Choice and Use of Practices to Support Young People Living with Mental Illness

A parent's response to a young person's mental illness can influence their recovery and wellbeing. Many parents devote considerable time and energy to supporting a young person experiencing mental illness and engage in numerous different practices to do so. Yet little is known about why parents use particular practices. This article explores this question through qualitative analysis of parent perspectives. Interviews with 32 parents of young people living with mental illness were analysed using constant comparative analysis. Findings suggest that parents' choice of and ability to carry out particular practices are shaped by: their knowledge and beliefs; their personal resources and constraints; and their social and service networks. Further, parents took active measures to optimize these influences. By understanding the complexity of their own potential influence on both knowing what to do and being able to do it, health professionals can better enable parents to support young adults experiencing mental illness.

Patient involvement in mental health care: one size does not fit all

BACKGROUND

Involvement of mental health-care patients in the decision-making processes is considered to be an ethical requirement. Health-care systems worldwide are increasingly emphasizing the value of participatory approaches. There is, however, no consensus on the definition of patient involvement. The literature is particularly inconsistent and lacks clarity.

OBJECTIVE

The purpose of this article is to clarify the concept of patient involvement in mental health care (MHC), taking into account its multidimensional nature.

SEARCH STRATEGY

We searched the literature in online databases from January 1998 until August 2010 using synonyms of 'patient involvement', combined with the terms 'mental health(care)'.

DATA SYNTHESIS

Based on 45 different descriptions found in the literature, we constructed a definition of patient involvement and we drew up a model identifying its determinants and outcomes.

RESULTS

We propose a comprehensive model of patient involvement to be used in MHC. This model can serve as a guide for policy makers and field workers to shape policies to stimulate involvement.

DISCUSSION AND CONCLUSIONS

There are three main problems in the literature concerning patient involvement. First, there is a proliferation of conceptualizations of the topic, leading to conceptual vagueness. Furthermore, there is a lack of quantitative data, and some aspects of involvement remain underexposed, such as the involvement of specific target groups and practical ways to shape the involvement processes. Involvement processes should be tailored to the specific target group and context.

Comparative review of family-professional communication: what mental health care can learn from oncology and nursing home care

Because family members take on caring tasks and also suffer as a consequence of the illness of the patient, communication between health-care professionals and family members of the patient is important. This review compares communication practices between these two parties in three different parts of health care: oncology, nursing home care, and mental health care. It shows that there are important differences between sectors. Mental health stands out because contacts between family members and professionals are considered problematic due to the autonomy and confidentiality of the patient. The article explores several explanations for this, and, by comparing the three health sectors, distils lessons to improve the relationship between family members and health-care professionals.

What has been learned from joint working between mental health professionals, patients and users of psychiatric services, their families and friends?

PURPOSE OF REVIEW

To outline what is known about collaborative work between the main stakeholders in mental health and psychiatry (professionals, patients or service users and family members). To learn from recent practice what are the main areas of joint work, what is working well, what are the key issues and problems and what has been learned from doing it.

RECENT FINDINGS

Service users and family members are valued in education and training. Service users as peer support workers have helped patients recover, and methods of participatory research can bring new insights. There is a need to support and build an evidence base for these new ways of working.

SUMMARY

The run-down of institutions, the new paradigm of recovery and human rights laws have led to increased joint working in the field of law and policy, research, education and training, service provision and coercion. Joint working challenges the old ways of knowledge creation and practices such as coercive treatment. More work is needed to build on what is being learned and move to genuine equality and partnership.