Making mental health service user involvement effective

Eva Cyhlarova

Mental Health Foundation

The Mental Health Foundation

• Only charitable, independent, UK

development agency in mental health and

learning disabilities

• Few equivalent organisations worldwide

• Rich mix of activities

• Research and policy into practice vision

across mental health and learning disabilities

• Mixture of client groups/audiences

Historical context

• Rapid development from radical ideology to contract specification

• Assumption that service user involvement is “a good thing”

• Consumer power is a limited analogy

Different roots

• Civil rights based v Consumerist• Collective v Individual• Separatist v Collaborative

Getting the basics right

1. Be clear about the purpose

2. Be clear about the limits of involvement

3. Communicate clearly and regularly

The tricky bits (i)Levels of involvement

1. Strategic

2. Operational

3. Personal

The tricky bits (ii)Effectiveness of involvement

1. Who – the people involved

2. What and how - the mechanisms and processes

3. Why – the impact of involvement

The tricky bits (ii)Key areas

1. Who – the people involved– Population – People using services– Population of people needing services– People who are involved

The use of community treatmentorders: by ethnic group

Any other Asian

Any other Black

African

Caribbean

White British

0 10 20 30 40 50 60 70 80 90

CTO patients General population

Proportion (%)

The tricky bits (ii)Key areas

1. Who – the people involved

2. What and how - the mechanisms and processes

The tricky bits (ii)Key areas

1. Who – the people involved

2. What and how - the mechanisms and processes

3. Why – the impact of involvement– Who is involved– How are people involved– Does it achieve its aim

Characteristics of an indicator

• Measurable• Auditable• Meaningful• Objective• Effectively measure change over time• Practical to implement

Involvement indicators Who How Why

Personal More people and greater diversity is better

Ensure a good range of mechanisms

Ensure clarity of purpose

Operational Check for bias to or against particular groups (e.g. age, gender, race, diagnosis)

Be aware of things that block particular groups or individuals

Ensure everyone involved understands purpose and limits

Strategic Ensure this is not the preserve of an elite

Diversity in approaches leads to diversity in involvement

Link involvement initiatives to observable outcomes

Long term objectives

• Changing the balance of power• Knowing when people know best• Helping them when they don’t

Contact Details

Dr Eva CyhlarovaMental Health Foundation9th FloorSea Containers House20 Upper GroundLondon SE1 9QBUnited KingdomTel: (020) 7803 1100

ECyhlarova@mhf.org.uk