Evaluation of user/carer involvement in planning mental health services Professor Mary Watkins, Alan Miles & Andy Dickens

Introduction l South & West Devon Health Authority commissioned an independent evaluation l 22-month evaluation period: Jan Oct 2002

Health Authority project l Previous consultation l Steering group l All stakeholders involved l Purpose

Aims of the evaluation project l Collate data l Analyse data l Make recommendations for future user/carer involvement

Literature review - user/carer involvement l Paradigm shift in 1990s (Edwards, 2000) l Levels of involvement (Goss & Miller, 1995) l Representativeness (Hopton, 1997; Forrest et al, 2000) l Best practice (Goss & Miller, 1995; Service First, 1999)

Methods l Non-participant observation l Semi-structured interviews l Documentary analysis

(1) Non-participant observation l Observed 5 steering group meetings l Used sociograms to record group dynamics l Meeting minutes supported observations

(2) Interviews l Interview role-play with volunteers l Interviewed steering group members l users & carers (n=13) l managers (n=4)

(3) Documentary analysis l Subscribed to ‘communication loop’ l Analysed all steering group correspondence

Results l 4 principle themes: l Membership l Meeting style l Sharing perception l Having a voice

(1) Membership l Minimal initial uptake l Purposive recruitment l ‘Open’ membership l Risk of unrepresentative sample

(2) Meeting style l Chairing styles l Group interaction l Balance of responsibility l Reporting structure l Training

(3) Sharing perception l Increased requests for representation l Barriers to productive working l Good links with organisations l Independence from Health Authority

(4) Having a voice l ‘Listening & responsive’ level of involvement (Goss & Miller, 1995) l Ambiguous role of steering group l User/carer & manager collaboration

Recommendations l Strategic recruitment l Forum structure l Training for managers and users/carers l Project Worker l Explicit good practice guidelines