Service user involvement: impact and participation: a survey of service user and staff perspectives

BMC Health Services Research

Diana Rose³  Mike Crawford²  Dee MacDonald¹  Marian Barnes¹  Edward Omeni³ 

[1] School of Applied Social Science, University of Brighton, Mayfield House, Falmer BN1 9PH, East Sussex, UK;Department of Medicine, Imperial College, Claybrook Centre, Claybrook Road, , London W6 8LN, Hammersmith, UK;Service User Research Enterprise (SURE), Institute of Psychiatry, Psychology and Neuroscience at King’s College London, De Crespigny Park, London SE5 8AF, UK

关键词: Health services research;    Patient and public involvement;    Service user involvement;    Mental health services;   

Others  :  1125865
DOI  :  10.1186/s12913-014-0491-7

 received in 2014-02-24, accepted in 2014-10-06,  发布年份 2014

【 摘 要 】

Background

Over the last 20 years governments around the world have promoted user involvement in an effort to improve the quality of health services. Despite the growing emphasis placed on user involvement in England, there is a paucity of recent studies looking at how service users and professionals perceive the outcomes of user involvement policies. This study aimed to examine the overall levels of participation in service user involvement in mental health services among professionals and service users and ascertain their views on the impact of involvement activity on various areas of service delivery.

Methods

A cross-sectional survey of service users and providers within community mental health services. The sampling was carried out across three mental health Trusts, two serving people living in inner-city areas and a third covering a mixed rural/urban population. A questionnaire with closed and open ended questions was used to gather the responses of service users and frontline professionals. As a mixed methods study, the analysis consisted of both quantitative and qualitative approaches.

Results

Three hundred and two service users responded to the survey with a response rate of 48%. One hundred and forty three frontline mental health professionals, 26.8% of those approached submitted questionnaires. Almost half of service users (N=138, 45.7%,) and healthcare professionals (N=143, 55.9%) reported having been involved in some form of user involvement activity. Although there were some differences in the responses of service users and frontline professionals, both groups reported that service user involvement was having a positive impact.

Conclusions

The findings show that, within the three mental health trusts examined in this study, service user involvement has become widespread and is perceived by both staff and service users to be a good policy. The study had some important limitations. The questionnaire used was based on existing literature, however it was not subjected to psychometric testing. In addition, response rates were low, particularly among professionals. Despite the limitations, the findings are encouraging, offering important of insight into views and experiences of service users and healthcare staff. Further studies are needed to assess and investigate the topic on a national level.

【 授权许可】

   
2014 Omeni et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Chamberlin J: User/consumer involvement in mental health service delivery. Epidemiol Psichiatr Soc 2005, 14(1):10-14.
• [2]Crawford M, Aldridge T, Bhui K, Rutter D, Manley C, Weaver T, Tyrer P, Fulop N: User involvement in the planning and delivery of mental health services: a cross‐sectional survey of service users and providers. Acta Psychiatr Scand 2003, 107(6):410-414.
• [3]Thornicroft G, Tansella M: Growing recognition of the importance of service user involvement in mental health service planning and evaluation. Epidemiol Psichiatr Soc 2005, 14(1):1-3.
• [4]Department of Health: National service framework for mental health. In. The Stationery Office London; 1999.
• [5]Crawford MJ, Rutter D, Manley C, Weaver T, Bhui K, Fulop N, Tyrer P: Systematic review of involving patients in the planning and development of health care. Br Med J 2002, 325(7375):1263.
• [6]May C, Montori V, Mair F: We need minimally disruptive medicine. Br Med J 2009, 339(7719):485-487.
• [7]Coulter A, Ellins J: Effectiveness of strategies for informing, educating, and involving patients. Br Med J 2007, 335(7609):24.
• [8]Cegala DJ, Street RL Jr, Clinch CR: The impact of patient participation on physicians’ information provision during a primary care medical interview. Health Commun 2007, 21(2):177-185.
• [9]Lindow V: Power, lies and injustice: the exclusion of service users’ voices. Ethics and Community in the Health Care Professions 1999, 154-177.
• [10]Nicholls V: Surviving User-led Research: Reflections on Supporting User-led Research Projects. 2003.
• [11]Cowan S, Banks D, Crawshaw P, Clifton A: Mental health service user involvement in policy development: social inclusion or disempowerment? Ment Health Rev J 2011, 16(4):177-184.
• [12]Kent H, Read J: Measuring consumer participation in mental health services: Are attitudes related to professional orientation? Int J Social Psychiatry 1998, 44(4):295-310.
• [13]Storm M, Hausken K, Knudsen K: Inpatient service providers’ perspectives on service user involvement in Norwegian Community Mental Health Centres. Int J Social Psychiatry 2011, 57(6):551-563.
• [14]Soffe J, Read J, Frude N: A survey of clinical psychologists’ views regarding service user involvement in mental health services. J Ment Health 2004, 13(6):583-592.
• [15]Solbjør M, Steinsbekk A: [Patient participation in hospital wards–health personnel’s experience]. Tidsskr Nor Laegeforen 2011, 131(2):130-131.
• [16]Solbjør M, Steinsbekk A: User involvement in hospital wards: Professionals negotiating user knowledge. A qualitative study. Patient Educ Couns 2011, 85(2):e144-e149.
• [17]Barnes M, Bowl R: Taking Over the Asylum: Empowerment and Mental Health. Palgrave, Houndmills, Hampshire; 2001.
• [18]Gagliardi AR, Lemieux-Charles L, Brown AD, Sullivan T, Goel V: Barriers to patient involvement in health service planning and evaluation: an exploratory study. Patient Educ Couns 2008, 70(2):234-241.
• [19]Gordon S: The role of the consumer in the leadership and management of mental health services. Australas Psychiatry 2005, 13(4):362-365.
• [20]Storm M, Knudsen K, Davidson L, Hausken K, Johannessen JO: “Service user involvement in practice”: The evaluation of an intervention program for service providers and inpatients in Norwegian Community Mental Health Centers. Psychosis 2011, 3(1):29-40.
• [21]Rise MB, Grimstad H, Solbjør M, Steinsbekk A: Effect of an institutional development plan for user participation on professionals’ knowledge, practice, and attitudes. A controlled study. BMC Health Serv Res 2011, 11(1):296. BioMed Central Full Text
• [22]Milewa T: User participation in service planning: a qualitative approach to gauging the impact of managerial attitudes. J Manag Med 1997, 11(4):238-245.
• [23]Rutter D, Manley C, Weaver T, Crawford MJ, Fulop N: Patients or partners? Case studies of user involvement in the planning and delivery of adult mental health services in London. Soc Sci Med 2004, 58(10):1973-1984.
• [24]Department of Health: NHS and Community Care Act. London: HMSO; 1990.
• [25]Department of Health: Putting People First: A shared Vision and Commitment to the Transformation of Adult Social Care. London: HM Government; 2007.
• [26]Department of Health: Health and Social Care Act 2012 (incl. fact sheets). London: HMSO; 2012.
• [27]Department of Health: No Health without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of All Ages. London: HM Government; 2011.
• [28]Census. ONS, London; 2001.
• [29]Rose D, Wykes T, Fleischmann P, Hogman G, Tonkiss F: User and Carer Involvement in Change Management in a Mental Health Context: Review of the Literature. 2002.
• [30]Rose D, Fleischmann P, Schofield P: User perceptions of the outcomes of user involvement. Int J Social Psychiatry 2010, 56(4):389-401.
• [31]Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006, 3(2):77-101.
• [32]QSR. QSR, Melbourne; 2010.
• [33]Beresford P: User involvement in research and evaluation: liberation or regulation? Soc Policy Soc 2002, 1(2):95-106.
• [34]Fadden G, Shooter M, Holsgrove G: Involving carers and service users in the training of psychiatrists. Psychiatr Bull 2005, 29:270-274.
• [35]Molyneux J, Irvine J: Service user and carer involvement in social work training: a long and winding road? Soc Work Educ Int J 2004, 23(3):293-308.
• [36]Forrest S, Risk I, Masters H, Brown N: Mental health service user involvement in nurse education. J Psychiatr Ment Health Nurs 2000, 7:51-57.
• [37]Livingston G, Cooper C: User and carer involvement in mental health training. Adv Psychiatr Treat 2004, 10:85-92.
• [38]Tmobranski PH: Nurse–patient negotiation: assumption or reality? J Adv Nurs 1994, 19(4):733-737.
• [39]Hickey G, Kipping C: Exploring the concept of user involvement in mental health through a participation continuum. J Clin Nurs 1998, 7(1):83-88.
• [40]Kalathil J: Dancing to Our Own Tunes. Reassessing Black and Minority Ethnic Service User Involvement, Reprint of the 2008 Report With a Review of Work to Take the Recommendations Forward, London, The Afiya Trust and National Survivor User Network (NSUN) 2011.
• [41]Rose D, Fleischmann P, Tonkiss F, Campbell P, Wykes T: User and Carer involvement in Change Management in a Mental Health Context: Review of the Literature. Report to the National Co-ordinating Centre for NHS Service Delivery and Organization R & D London: Service User Research Enterprise, Institute of Psychiatry, De Crespigny Park 2002.
• [42]Pyke J, Samuelson G, Shepherd M, Brown N: Shaping mental health services. Can Nurse 1991, 87(5):17.
• [43]Ross K: The emergence of stakeholder contributions. Can J Commun Ment Health 2000, 19(2):156.