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The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration.

The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice.

Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care.

Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic.

Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors.

The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise.

This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

Emergency services face increasing frontline pressure to support those experiencing mental health crises. Calls have been made for police and ambulance staff to receive training on mental health interventions, prevention of risk and inter-professional collaboration. Mental health simulation training, a powerful educational technique that replicates clinical crises for immersive and reflective training, can be used to develop competencies in emergency staff. This study aims to evaluate the effectiveness of mental health simulation training for police and ambulance staff.

In total, 199 participants from the London Metropolitan Police Service and London Ambulance Service attended a one-day simulation training course designed to promote effective and professional responses to mental health crises. Participants took part in one of six simulated scenarios involving mental health crisis before completing structured debriefs with expert facilitators. Participants’ self-efficacy and attitudes towards mental illness were measured quantitatively using pre- and post-course questionnaires while participants’ perceived influence on clinical practice was measured qualitatively using post-course open-text surveys.

Statistically significant improvements in self-efficacy and attitudes towards mental illness were found. Thematic analyses of open-text surveys found key themes including improved procedural knowledge, self-efficacy, person-centred care and inter-professional collaboration.

This study demonstrates that mental health simulation is an effective training technique that improves self-efficacy, attitudes and inter-professional collaboration in police and ambulance staff working with people with mental health needs. This technique has potential to improve community-based responses to mental health crises.

The purpose of this paper is to examine the value of appreciative inquiry (AI) methodology in enabling co-productive work within mental health service development.

The methodology of AI is described and observations on its use in mental health service improvement are considered.

AI is a really helpful tool in supporting service improvement and is particularly applicable in mental health discussions involving service users and carers. Many service users and carers engaging with service development discussions have had adverse past experiences which can inhibit their successful contribution to planning discussions. AI allows a more positive reflection on how services can be improved which can help achieve positive results.

AI methodology is a really useful tool in supporting improvement discussions across health, and other public, services, and is particularly valuable in engaging mental health service users and carers in such activity.

The method is useful across service development needs and could be developed to support mental health service improvement locally, regionally and nationally. Developing the use of this method could make a real contribution to improving relations between service users, carers and health staff and support meaningful and positive change in the delivery of mental health services.

Helping to overcome dissonance between service users and carers, and health staff and commissioners; and developing the use of appreciative enquiry could enhance the value of co-production as a key driver for service improvement.

The author is aware of little discussion of the value of appreciative enquiry in the growing literature around co-production in mental health.

This article aims to describe the development of secure services for women with intellectual disability in the UK and to outline what is known about their mental health needs.

The paper is a general review which is based on what is known historically about the subject, findings from the current literature and the author's own personal knowledge of these specialist services.

Secure services for women with intellectual disability have developed out of mainstream forensic and learning disability services.

Although there is a reasonable body of literature on offending in the intellectually disabled population as a whole, little of this is specific to women. Despite this, the evidence there is suggests that women continue to require secure services and that they have significant mental health needs.

The purpose of this paper is to identify what key factors multi-disciplinary teams (MDT) deem as most important when making the decision to move service users from one level of security (including low, medium and high secure services) to another. The researchers used the findings from this study to further develop a tool; the assessment for level of security tool (ALS), which aims to structure and streamline this decision-making process.

Data from 18 interviews (MDT staff) were analysed using the Delphi technique (Dalkey and Helmer, 1963). This revealed a range of factors discussed when considering service users moves. Participants were asked to rate these factors in accordance with the Delphi which resulted in the removal of certain less important factors based on their scores. The researchers then compared these factors of relevance with a checklist of 16 items previously proposed by a consultant psychiatrist within the trust. This comparison allowed the researchers to highlight any similarities and differences present.

Findings from staff interviews revealed a range of 20 clinical factors perceived as essential to this process including procedural, relational and physical security aspects. However, variations were evident between the MDT priorities (20 items) and the originally proposed list. This emphasised the need for a tool which facilitates a holistic and streamlined approach.

The findings from this research have resulted in the development of the ALS tool comprising of 18 key factors.

It is envisaged the development of the ALS tool will not only facilitate and structure the decision-making process but also ensure a person-centred approach. This is because the ALS allows for a holistic approach based on an array of factors deemed important to that particular service user. Furthermore, the ALS tool contributes towards the paucity of published structured professional judgement tools needed to make such decisions.

Student mental health is a major challenge for higher education in the twenty-first century. Students undertaking healthcare professionally affiliated courses can experience additional pressures that negatively impact on their well-being and can make it more difficult to access support. The paper aims to discuss this issue.

To address some of these challenges, the Bridge Network was established in one healthcare school in a higher education institution. It is a peer support network co-produced with students studying on healthcare courses to provide group-based support to promote mental well-being. Student peer group facilitators draw on their own lived experience of mental health challenges or of being a carer. The groups provide a safe space for students who may experience mental health difficulties to share, gain support and connect with each other. This paper explores the journey of setting up the Bridge Network.

Although the group has been well received and various factors have supported its establishment, there are several difficulties that the network has faced. Power imbalances between students and academic staff have been challenging for the co-produced design, alongside enabling positive and safe discloser for healthcare students. However, the network has raised the profile of mental well-being for healthcare students and encouraged supportive conversations about the issue as well as providing enriching volunteer opportunities.

The Bridge Network is an innovative development reflecting best practice within mental healthcare. However, to ensure spread and sustainability, alignment with organisational strategy is required.

The paper explores the strengths and challenges of establishing peer support for students undertaking vocational healthcare courses.

Stakeholder management is not yet incorporated into the standard practice of most healthcare providers. The purpose of this paper is to assess the applicability of a comprehensive model for stakeholder management in mental healthcare organization for more evidence-based (stakeholder) management.

The assessment was performed in two research parts: the steps described in the model were executed in a single case study at a mental healthcare organization in the Netherlands; and a process and effect evaluation was done to find the supporting and impeding factors with regard to the applicability of the model. Interviews were held with managers and directors to evaluate the effectiveness of the model with a view to stakeholder management.

The stakeholder analysis resulted in the identification of eight stakeholder groups. Different expectations were identified for each of these groups. The analysis on performance gaps revealed that stakeholders generally find the collaboration with a mental healthcare provider “sufficient.” Finally a prioritization showed that five stakeholder groups were seen as “definite” stakeholders by the organization.

The assessment of the model showed that it generated useful knowledge for more evidence-based (stakeholder) management. Adaptation of the model is needed to increase its feasibility in practice.

Provided that the model is properly adapted for the specific field, the analysis can provide more knowledge on stakeholders and can help integrate stakeholder management as a comprehensive process in policy planning.

For decades, artificial intelligence (AI) has been utilized within the field of mental healthcare. This paper aims to examine AI chatbots, specifically as offered through mobile applications for mental healthcare (MHapps), with attention to the social implications of these technologies. For example, AI chatbots in MHapps are programmed with therapeutic techniques to assist people with anxiety and depression, but the promise of this technology is tempered by concerns about the apps' efficacy, privacy, safety and security.

Utilizing a social informatics perspective, a literature review covering MHapps, with a focus on AI chatbots was conducted from the period of January–April 2019. A borrowed theory approach pairing information science and social work was applied to analyze the literature.

Rising needs for mental healthcare, combined with expanding technological developments, indicate continued growth of MHapps and chatbots. While an AI chatbot may provide a person with a place to access tools and a forum to discuss issues, as well as a way to track moods and increase mental health literacy, AI is not a replacement for a therapist or other mental health clinician. Ultimately, if AI chatbots and other MHapps are to have a positive impact, they must be regulated, and society must avoid techno-fundamentalism in relation to AI for mental health.

This study adds to a small but growing body of information science research into the role of AI in the support of mental health.