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1 – 4 of 4Lucy Simons, Steve Tee and Tina Coldham
Mental health education aims to develop valuesbased practice to support practitioners in clinical decision‐making. Values‐based practice requires high levels of cultural…
Abstract
Mental health education aims to develop valuesbased practice to support practitioners in clinical decision‐making. Values‐based practice requires high levels of cultural competence achieved through service user participation in professional preparation. The degree of service user participation remains dependent on the values of programme providers.In this paper, we consider whether strategies to involve service users in mental health professional education can support the principles of valuesbased practice. To do this, we have drawn on the findings from qualitative studies of educators' practices and their views regarding service user involvement. Values‐based practice requires self‐awareness of values impacting on decisions and knowledge derived from service users' personal accounts. The studies suggest that while opportunities exist for service users to present their accounts, few examples of service user involvement facilitated deeper examination of values underpinning decision‐making. Enabling service users to influence values‐based practice development requires more authentic participatory approaches. Educators valued the contribution of service users' experiential knowledge to the learning process, but there was less evidence of educators' values base that would model commitment to the empowerment of service users.
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– The aim of the research is to assess the extent and value of mental health service user (MHSU) involvement in research in England.
Abstract
Purpose
The aim of the research is to assess the extent and value of mental health service user (MHSU) involvement in research in England.
Design/methodology/approach
This is a knowledge review, including academic and “grey” literature, and documented testimonial evidence.
Findings
The involvement of MHSUs in mental health research has become mainstream. There is clear evidence that involving MHSUs in research adds value. Four gaps in the literature were identified. First, a lack of evidence from non-service-user researchers about their experience of working with MHSUs. Second, a lack of recognition that anyone involved in research may hold more than one role. Third, failure to treat carers as separate from MHSUs, or – often – to include them at all. Fourth, a lack of understanding that MHSUs may have a useful role to play in research on topics other than mental health.
Research limitations/implications
The literature would benefit from some evidence about non-service-user researchers’ experiences of working with MHSU researchers. Carers should be recognised much more widely as different from MHSUs and with a valid role to play in mental health research from their own perspectives. MHSU researchers, and carer researchers, should be offered opportunities for involvement in research on topics other than mental health.
Practical implications
The evidence shows that involving service users in research can benefit everyone involved and the research itself. The process can be challenging for all concerned. However, there is now plenty of guidance about how to involve service users in research for maximum benefit to all (e.g. Faulkner, 2004b; SURGE, 2005; Morgan, 2006; Tew et al., 2006; Kotecha et al., 2007; Schrank and Wallcraft, 2008, pp. 243-247; Leiba, 2010, pp. 160-169; Armes et al., 2011; Morrow et al., 2012, p. 114). This guidance should be consulted by researchers, funders, ethics committees, and other stakeholders at the earliest possible stage of any relevant project.
Social implications
It is essential to recognise and acknowledge that anyone involved in research may hold more than one role. Embracing multiple and mutable identities is not an easy process, as the literature shows, and attempts to do so are likely to produce resistance at every level. Nevertheless, the example of the survivor researchers suggests that doing this has the potential to enrich our individual and collective experience, and therefore society as a whole.
Originality/value
The paper is written by an independent researcher who is also a carer for people with mental health problems: a viewpoint which is rarely found in the literature. The literature suggests that power imbalances and identity issues are at the root of most difficulties and gaps. Social identity and categorisation theory offers a useful theoretical perspective. The paper will be of value to anyone interested in mental health research, whether as a student, service user/survivor, researcher or teacher.
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Alistair Hewison, Emma Hodges, Sundaravadivel Balasubramanian and Tina Swani
The purpose of this study is to report how the palliative and end of life care community in one region of England worked together to create a new model for integrated…
Abstract
Purpose
The purpose of this study is to report how the palliative and end of life care community in one region of England worked together to create a new model for integrated palliative and end of life care to respond to the challenges of changing demography, the need to reduce unnecessary hospital admissions of people nearing the end of life and to improve the quality of provision in line with current policy.
Design/methodology/approach
A co-production approach to system transformation was adopted involving 73 members of the palliative and end of life care community in one region of England.
Findings
A new model for the delivery of integrated palliative and end of life care services was produced. The breadth of membership of the co-production working party and constructive/collaborative working helped ensure a viable model was produced.
Practical implications
Although systems’ thinking perspectives can help address the challenges of large-scale transformation because they focus on promoting the value of relationships, recognise the nuances of context and the need to understand system behaviour over time, the potential for systems to benefit from this approach is limited by the complexity of the processes involved and the sheer number of issues to be addressed in practical terms by policy makers and change leaders.
Originality/value
The paper explores the contribution that theories of large-scale transformation can make to the design of palliative and end of life care services in health and social care.
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