User involvement: Substance or spin?

Abstract

Background: Department of Health policy guidelines state that people who use mental health services should be involved in all levels of planning and delivery of care they receive. Service standards were introduced in a mental health rehabilitation service to address user involvement in staff recruitment, service evaluation, organisation and planning, staff training, advocacy, care planning and self-assessment. Aims: To audit the user involvement service standards. To identify further improvements for user involvement and to consider whether user involvement influenced the culture of care. Method: A collaborative action-orientated partnership between a user-researcher group and a clinical psychologist was used. Structured interviews with staff were undertaken to ascertain the levels of implementation of service standards addressing user involvement. Results: High levels of user involvement were found for staff recruitment, planning and organising services and regular meetings for users. Established but less successful levels in such areas as annual surveys eliciting users' views, evaluation of services and self-assessment. Modest levels of user involvement were found for staff training and links with advocacy services. Conclusions: User involvement addresses some of the current limitations in the conceptual frameworks adopted to describe mental distress. Further development of user involvement requires the continued support of staff and additional resources from health services. Declaration of interest: None.