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Although work has a fundamental role in the individual’s psychological well-being, the vast majority of mental health service users are not in employment. This is the result of various barriers that impede their work re-integration process despite their desire to work. Apart from the illness’ symptoms, these barriers are strongly associated with the negative effects of long-term unemployment, the negative stereotypes and attitudes towards mental health service users and the fear of losing disability benefits. There are several occupational intervention models aiming at vocational rehabilitation of mental health service users. Arguably, the Individual Placement and Support (IPS) model of supported employment has proved to be more effective compared to other models. This chapter presents an innovative career counselling approach that combines elements from the IPS model and from the newly emerged career theories that have been developed to address today’s world of work challenges. This model was developed by the Pan-Hellenic Association for Psychosocial Rehabilitation and Work Integration (PEPSAEE) in Greece during the recent major economic crisis. Further implications of the model’s implementation regarding vocational rehabilitation of mental health users as means for social inclusion are discussed.

The notion of mental health service user involvement in curriculum design and delivery has become commonplace over recent years. However, concern has been expressed that the rhetoric has not matched the reality. In particular, service user involvement has tended towards either tokenism or over‐sensitivity to the point of near inertia. By contrast, this paper describes a project that took a pragmatic approach and was designed to make involvement in curriculum planning, design and delivery meaningful and worthwhile for service users, students and educators alike. The paper has two principal objectives. In the first instance, it outlines the strategy for involvement that was used to inform curriculum design and delivery at the University of Abertay Dundee. This was grounded in the academic literature. Second, it provides an evaluation of this strategy based on practical experience and identifies some of the difficulties that must be overcome to work in a collaborative manner. In so doing, it examines some of the common concerns of educational staff, service users and students in relation to service user involvement. In conclusion, we provide recommendations for educators seeking to involve mental health service users in a meaningful manner in both the design of training programmes for mental health workers, and in their delivery.

The training of future mental health professionals offers one avenue of change to improve service user and carer involvement in mental health services. This study looked at experiences of trainees on the University of Surrey's Clinical Psychology Doctorate programme in involving service users and carers on training placements. Twenty trainees completed a self‐report semistructured questionnaire providing qualitative data that were analysed using thematic analysis. A number of benefits of service user and carer involvement in training were identified as well as practical considerations, including factors that might facilitate or limit such involvement on training placements. It is intended that the findings will prove useful to others involved with the training of mental health professionals.

This paper aims to capture the views of forensic mental health service users; focusing on how services promote the aspiration to work, the development of skills for work, and the vocational rehabilitation process. It seeks to provide insight into forensic mental health service users' views on the barriers and enablers to accessing work together with suggestions for enhancing practice, and implications for further research.

Ten participants from a range of forensic mental health services throughout Scotland took part in semi‐structured interviews. Participants were involved in either paid work, voluntary work or work preparation. Interpretative phenomenological analysis (IPA) allowed exploration of an individual's lived experiences and how they make sense of this.

Service users valued the opportunity to address vocational issues at the earliest opportunity in their rehabilitation. Work had an overwhelmingly positive impact on mental health. Analysis of interview transcripts revealed three master themes: “Normalising my life”: the positive impact of work; “Gradual steps”: facing barriers; and “Practical help and encouragement”: feeling supported. There is much to gain from good multidisciplinary rehabilitation within secure hospitals and the community, with work playing an important role in recovery and symptom control. Forensic services should focus on employment and the aspiration to work early, demonstrating awareness that attitude and the aspiration to work are a much more reliable indicator of success than diagnosis and mental health symptoms.

Few qualitative studies have investigated service users' views of work within forensic mental health, yet such information can be crucial to enhance and improve service delivery.

In 2008, Mind in Bexley received a research development grant from the Big Lottery Fund and a training grant from Bexley Care Trust to empower service users to participate and contribute to a pilot research project. The project aims were to work with, develop, train and support service users as researchers, in order to record the narratives of service users who have common experiences of mental health distress and treatment. The research development project set up an advisory group, created and developed a partnership with the University of Kent and provided workshops and training sessions to explore some of the principles of research and ethics. In addition, the group undertook a preliminary literature review, developed and refined a research questionnaire and piloted interviews with six service users. Many issues were raised and lessons learned during the planning and conduct of the project. This paper discusses the process and reflects on aspects of the project's design and delivery. In addition, this paper highlights some of the difficulties in undertaking service user research and suggests recommendations as to how to overcome some of these complex issues.

The modernisation of mental health day services has been shaped by concerns about the social exclusion of people with enduring mental health problems. Initiatives have emphasised the use of mainstream facilities and an individualised approach. In contrast, service users have sought to safeguard opportunities for peer support in safe places. This participatory action research brought together service users, staff and others involved, to explore how these different views could be transformed into modernised services. The research took place in an outer London borough from 2003‐2007, using varied methods to explore social networking, including a visual method, action research groups and individual interviews. The research was designed and adapted to enable the involvement of people with different capacities and interests. Each stage generated findings for local modernisation, pointing to the importance of a safe space, service user knowledge of social and recreational activities and how self‐help groups develop and thrive. The final reconfiguration of local services reflected these research outcomes. Credible and useful outcomes can be achieved from collaborative research, allowing time and creating opportunities to shape interpretations of policy. Emerging initiatives are more likely to reflect service user perspectives and receive their support.

The emphasis on outcomes rather than process is an area that is receiving significant attention across the delivery of public sector services, and the question ‘so what?’ is increasingly being asked of service providers. With service user self‐direction being the focus of both provision and commissioning over the coming years, there will be an increasing need to justify the delivery and development of social care in terms of the end result. Strong leadership and vision is required across the public sector if this change, in both organisational culture and service user expectation, is to be achieved.Leadership as both a competency and an organisational function has been well researched within health and social care. The literature largely points towards the need for clarity and strength within the strategic vision, especially when considering the management of change and multifaceted partnerships, both of which are crucial to the delivery of social care outcomes. The actual detail of the outcome framework, and the means by which it can be measured and quantified, is still an area of debate, and as such the aim here is to highlight some of the benefits and barriers that may be faced as the reform of the social care system evolves, with a specific focus on the impact that leadership can have on the delivery of an outcome‐focused mental health social care serviceThe analysis of outcome‐focused organisations is a relatively new concept in health and social care, and as such this paper seeks to debate the evidence in terms of whether leadership contributes to better service user outcomes in mental health social care. Dynamics within organisations, professions and with service users are all key considerations in the achievement of positive outcomes, and the role of the leader is to empower the staff group to power share and move towards co‐production in order to embed choice, control and service user contribution in the overall philosophy and culture of mental health service provision and developments.The overall conclusions of this paper are that leadership is important in terms of shaping services, ensuring governance and promoting innovation, and as a result it is possible to suggest that leadership and positive outcomes do have a direct correlation.

Mental health service user involvement in education has gained momentum and prominence over the past decade, but service user involvement in the assessment of students' practice remains underdeveloped. This paper reports findings from a qualitative analysis of documentary data that captured service users' feedback to mental health student nurses about their practice. Third year mental health nursing students in acute inpatient placements were required to elicit, record and reflect on the feedback that service users gave them about their practice.One hundred and eighty eight accounts of this feedback were analysed and findings are presented in terms of the methods that students used to gain feedback and the issues that emerged from this. The analysis also explored the role that students appear to play in care delivery and what aspects of their role service users most valued. The impact that the feedback had on the students' learning and practice is examined and discussed in relation to future opportunities for, and likely barriers to, continued service user involvement in assessing students' practice.

The physical health needs of people with mental health problems are currently under addressed and often ignored, both in training and in practice. The PRIMROSE trial intervention was designed to remedy that – focusing in particular on risk of cardiovascular disease (CVD). This paper describes how people with experience of using mental health services and carers contributed to the development of the PRIMROSE intervention. It draws out key messages for educators, researchers and practitioners.

Using a case study approach the paper outlines how a Third sector organisation supported the study team in setting up a Lived Experience Advisory Panel (LEAP), drawing on a pre-existing model and recent thinking about service user and carer involvement in research. It is described how the approach sought to engage wider involvement of people with an interest in CVD while also offering more focused input into specifically the development of the trial intervention.

An innovative approach was taken whereby a large LEAP, comprising 27 service users and carers, was supporting the development of the study mainly through e-mail and web updates and feedback, while a sub-group of the LEAP, with eight members, met three times and had a focus on inputting ideas into the development of the intervention. The creation of a LEAP proved helpful to the project, resulting in an enhanced and more relevant intervention – summed up in a series of eleven recommendations. Appointment of an independent chair of the sub-group proved invaluable and there is learning from this project for other similar initiatives.

This study has value for others who are developing practice interventions. A range of suggestions were made which will have relevance for training, ensuring that physical health issues are not ignored. There is much to learn too from the process of this project, for the involvement of service users and carers in research, education and in practice development.

This paper reports on the evaluation of a scheme to promote service user involvement in the care delivered by a mental health trust. A case study methodology was employed to describe the particularity of the scheme in context as experienced by service users and staff involved in its delivery. Mixed methods of semi‐structured interviews and focus groups created the opportunity for all stakeholders to engage in action research through a mutual learning process about the scheme in operation with a view to making changes to improve and develop it in the future. The qualitative data collected was content analysed and grouped according to key themes, which included the benefits of the scheme, the conditions for it to work successfully, suggested changes, limitations of the scheme, and service user involvement generally in a hospital setting. The role of service users as both paid scheme co‐ordinators and volunteer representatives highlights the contribution that people who use mental health services can play in influencing service delivery when employed in relevant and appropriate roles within a mental health organisation.