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There is a special offer for our customers! In addition participants were asked about the overall impact of user involvement. The questions in section two of the questionnaire were presented as follows:. Section two of the questionnaire also included a series of open-ended questions. Participants were asked to identify the positive and negative impact of user involvement activity.
Those who were unwilling or unable to write their responses in the open ended text box sections of the questionnaire could give a verbal response. In such cases, answers were transcribed by the interviewing researcher. In Section three of the questionnaire service user participants were asked to provide additional details, including their age in age bands , ethnicity and gender.
Service users were asked additional information about their diagnosis and length of time they had been in contact with mental health services. Mental health professionals were also asked about their professional background social work, nursing and length of employment within mental health services. The analysis of quantitative data involved calculating the frequency and distribution of survey responses.
Descriptive statistics were used to: All quantitative data analysis was conducted using SPSS version We used a binary logistic regression to examine factors associated with whether or not service users and front-line professionals had been involved in user involvement activities. Diagnostic categories were omitted from the list of predictor variables due to the low response rate associated with this question in the survey.
A thematic content analysis was used in the review of the data from the open ended sections of the questionnaire [ 31 ]. The analysis was inductive, although it drew on what is already known about the positive and negative outcomes of service user involvement [ 5 — 10 ]. Responses were read several times by the primary researchers to identify codes and themes. The overarching focus was to examine the positive and negative aspects of service user involvement and encapsulate the responses of study participants to facilitate further analysis.
Agreement was sought with each participating Trust to conduct the survey. Detailed information was given to each participant about the study and its purpose. In the case of professionals the information was provided in written form due to the online recruitment strategy.
In the case of service users, verbal information was provided together with supplementary information sheet. Participation in the study was voluntary and respondents could withdraw from completing the questionnaire at any time. Three hundred and two service users agreed to participate in the survey. Ninety five professionals submitted a completed online questionnaire. A further 48 members of staff were approached directly by a member of the research team and completed a paper version of the questionnaire.
Of the surveyed service users , Participation levels among professionals were similarly high with Percentage of service users and mental health professionals involved in one or more area of service user involvement. Both social workers and community psychiatric nurses associated positive benefits with service user involvement in mental health services. In contrast, a small minority of professionals felt that user involvement was a negative or no influence.
Professional perceptions about the overall impact of service user involvement on mental health services. Levels of reported positive impact of user involvement differed across the three trusts. Levels of participation across the various areas of user involvement were also significantly lower in Trust C.
White professionals were associated with a higher likelihood of being involved in user involvement activity. In terms of professional background, social work professionals were more likely to be involved than community psychiatric nurses. Increasing length of employment was a further predictor associated with service user involvement.
Among service user participants, increasing length of contact with services and gender were associated with a higher likelihood of participating in involvement initiatives, with men being more likely to have experienced user involvement activities than women. In terms of ethnicity, service users from BME backgrounds were more likely to be involved user involvement initiatives than white service users.
Odds ratios associated with predictors of being involved in service user involvement. Service users in Trust A were associated with a higher likelihood of being involved in user involvement activity, while service users in Trust C were least likely. As for professionals, participants in Trust C were the most likely to be involved and professionals in Trust B the least likely.
Benefits and disadvantages of service user involvement reported by service users and staff. Overall, 35 service users and 26 professionals identified user involvement in decision making as the important outcome and this was the response most frequently highlighted as a positive benefit of user involvement.
Professional respondents often referred to user involvement as a way of making services more responsive to service user needs. Service users seemed to place less emphasis on this highlighting general service improvement and positive changes to the way service are delivered.
In their comments on the benefits of user involvement 11 service users mentioned opportunities for social interaction as a positive aspect of user involvement. Seven mental health professionals identified service users as a valuable source of knowledge, seeing this input as a positive aspect of user involvement. Both service user and professional respondents generated fewer ideas about the negative impact of user involvement. In their comments on the negative impacts of user involvement, 8 service users observed that mental health issues may prevent people from taking part in user engagement activity.
Professionals highlighted the issue of overly negative and unconstructive criticism from campaigners as a negative outcome of user engagement initiatives, with 12 respondents identifying this as a problem. Issues of representativeness were also raised as a negative outcome, with 8 professionals stating that those who become involved may not be representative of the larger population of service users, thus making them unsuitable to speak on behalf of others.
Tokenistic practices and involvement initiatives that do not lead to change were identified by 6 professionals as a significant negative aspect of service user involvement. The main purpose of the study was to examine the overall levels of participation in service user involvement across three mental health trusts in the UK. In addition, the study aimed to ascertain the views of service users and professionals on the impact of user involvement on different areas of service delivery.
High levels of service user involvement were observed among both professional and service user respondents.
Participants who had taken part in user involvement work were likely to report a positive impact of the type of user involvement activity they had experienced. With a significant proportion of the sample recruited from community day centres, service user respondents were most likely to have participated in running day services also reporting a positive impact of user involvement in this area.
Service users were also likely to have participated in service evaluation and providing feedback about mental health services. We found that mental health workers were most likely to have direct experience of user involvement in training, a finding which is reflected in other studies highlighting the mainstream position of user involvement in professional education and training [ 34 — 37 ].
In addition, a significant majority of professionals felt that service user involvement in training was having a positive impact. Fewer service users had direct experience of user involvement in training. Service users were also less likely than professionals to state that user involvement was having a positive impact in this area.
The finding is interesting as it indicates that user involvement in training is highly valued by frontline clinicians with a significant number of professionals having directly experienced user involvement in this area and reporting a positive outcome of such activity.
Professionals may be more aware than service users about the positive impact of users on their training and professional education, as service users may not directly see the outcome of their involvement in this area.
A significant number of both professionals and service users had experience in user involvement activity associated with service evaluation, although professionals were more likely than service users to report a positive impact of this form of engagement.
This is not surprising as the results of evaluation initiatives, such as the national patient survey, are rarely fed back to patients and professionals may be more aware of the outcomes of service improvement initiatives.
Both service users and professionals were least likely to have experience in the area of commissioning services. This may be due to the highly specialised nature of commissioning processes within mental healthcare settings, but it also may reflect the limited opportunities to become involved in his area of user engagement. This is explained further by the findings reported by Storm et al.
Trnobranski [ 38 ] points out that characteristics such as cultural background, age, gender and previous health care experience may influence the extent to which service users are willing to be involved in decisions about their care [ 39 ].
Organisational and professional culture, as well as the approach taken to involving service users may also determine the extent to which various groups of service users can become involved in decision making.
In terms of gender, male service users were more likely to have had experience of service user involvement than female service users. The findings presented here highlight the need for further research focusing on how the approach to gender in mental health service organisation and delivery may influence participation in service user involvement.
Ethnicity was also shown to be a predictor for user involvement, with service users from BME backgrounds more likely to have experience in service user involvement activity. This finding is interesting, particularly when considering the context of ongoing concerns about mental health inequalities among minority ethnic groups in England.
The results may highlight the increased momentum gained by Black and Minority Ethnic service user-led groups in the two inner city Trusts covered in the study and the growing emphasis placed on involving service user from BME groups [ 40 ].
There was partial support for the first hypothesis of the study. In support of our second hypothesis we found that service users in Trust C, a mainly rural location, were less likely to participate in user involvement.
When compared to Trust A and B, participation was higher among professionals, however, significantly lower among service users. Factors, such as the geographical location, transport and the size of the service, may significantly determine how user engagement is experienced by service users and the extent to which they can become involved.
Similarities were found in the perspectives of users and professionals on the benefits and disadvantages of user involvement activities. Both service users and staff identified positive outcomes of user involvement, such as giving service user a say over how mental health service are delivered. Service users and professionals also highlighted improvements in services as a favourable outcome of involvement activity.
Key differences were also identified. While service users identified opportunities for social interaction as a benefit of user involvement, this outcome was not mentioned by professional respondents.
The finding is interesting as it underlines a key difference in perspective on the role and advantages of user involvement. As highlighted by Lindow [ 9 ] service providers may have very different priorities on a variety of aspects of service provision. While providers may perceive user involvement as being part of an overall strategy in delivering better and more responsive services, service users may derive personal benefits which are life enhancing in general.
A minority of participants highlighted negative aspects of user involvement. Amongst the disadvantages, professionals highlighted negativity and excessive criticism from service users. On the other hand, service users perceived as lacking the skills to participate at higher levels are easily overlooked for being unprofessional or misinformed. Both service user and professionals highlighted the potential for service user involvement to harm service users.
Future research should examine the negative effects of service user involvement on the health and wellbeing of those who take part, in an effort to understand how such problems arise and how they might be prevented in the future. There is a paucity of recent research assessing the outcomes of user involvement in the UK, in particular following the more recent changes in healthcare, which have further emphasised the central importance of service user involvement in mental health service provision.
The findings in this study indicate that user involvement has become widespread and mainstream across the three sampled trusts. Both service users and professionals were satisfied with the outcomes of their participation in user involvement activity. Perceptions and judgements about the impact of user involvement are largely positive, which may indicate that user involvement is perceived by both, service users and professionals, to be a good policy within mental healthcare, worthy of ongoing support and participation.
The findings provide some reason for optimism, particularly when considering the growing emphasis on user involvement across Europe and North America in recent decades. Literature suggests that the involvement of service users at higher decision making levels and the development of user-controlled services are have had a longer history in the USA and Canada [ 42 , 43 ].
While the findings presented in this study point to the mainstreaming and widespread prevalence of service user involvement, it would be prudent to learn from the American and Canadian experience and continue to expand the opportunities through which people can influence and shape the services they receive. An important strength of the current study lies in its broad perspectives on service user involvement and the diverse range of user involvement mechanisms covered in the study.
Furthermore participants were able to elaborate on their positive and negative experiences associated with user involvement. The inclusion of professionals, including social work and psychiatric nursing practitioners, added further depth to the study by encompassing multiple viewpoints on the subject, ensuring greater confidence in conclusions drawn from each group of respondents.
A further strength of the study was the sampling method. Service users were recruited from ordinary clinical contexts including community mental health clinics, day centres and community based substance misuse services. All participants were recruited and interviewed in person by a member of the research team. The survey has some important limitations.
While the questionnaire we used was based on existing literature, was acceptable to service users and had strong face validity, it was not subjected to formal psychometric testing.
Although service users were asked about their experience of service user involvement in the various areas of user involvement activity, the survey did not address the level of experience of service users. There was a high degree of variation in the interpretation given by service users about the areas of user involvement covered in the survey.
For example, many although not all of those who reported experience of user involvement in running day services had not participated in the management of high level decision making within such services but had contributed to in other ways, such as volunteering or had participated in organising groups and activities.
Similarly, many of those who reported being involved in service evaluation had simply filled in a questionnaire or submitted a feedback form. However, regardless of the level of service user involvement, service users were optimistic about the positive impact of their engagement in user involvement activity.
Another limitation of the study is possible response bias. Despite researchers asking people to express their thoughts freely we cannot rule out the possibility that some staff and patients felt obliged to give a positive account of any experience of service user involvement activity.
People with an interest in service user involvement may have been both more likely to participate and more likely to express positive views than those with limited experience or interest in the subject.
Despite these possible limitations, efforts were made by the research team to include comments both positive and negative from those who had not been involved in service user engagement activities. The poor response rate to the online survey targeting mental health professionals was further limitation. Having only received responses from a small minority of professionals approached to take part in the study, we are uncertain about the extent to which these views can help us understand levels of participation and the views of providers on user involvement.
Nonetheless, the responses we obtained regarding the advantages and disadvantages of user involvement offer some insight on the experiences of front line staff working in NHS mental health services. The study was part of a larger multi-centre investigation. When we drilled down from the survey findings using qualitative, ethnographic methods, the picture was considerably more complex.
This paper set out to determine the overall levels of service user involvement among professionals and service users within three mental health trusts. The study also examined the views of service users and health care staff on the impact of user involvement on various areas of service delivery. The findings have shown that there is a high level of participation in service user involvement activity and a general endorsement that involvement has a positive impact.
The percentage of service users and professionals who reported positive outcomes from activities they have been involved with was high, regardless of the type of activity they had experienced and their level of engagement in user involvement work.
The findings suggest that service user involvement has become a mainstream policy across the three trusts examined in the study. Further studies are needed to assess the levels of participation and perceptions of service user involvement on a national level.
We would like to acknowledge the help of Clinical Studies Officers from the Mental Health Research Network in contributing to recruitment for the surveys. EO and DM collected the data. EO, MC and DR analysed the findings and all authors contributed to the critical appraisal and write up of the paper.
All authors read and approved the final manuscript. National Center for Biotechnology Information , U. Published online Oct Received Feb 24; Accepted Oct 6. This article has been cited by other articles in PMC. Abstract Background Over the last 20 years governments around the world have promoted user involvement in an effort to improve the quality of health services.
Methods A cross-sectional survey of service users and providers within community mental health services. 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.
Mental health services, Service user involvement, Patient and public involvement, Health services research. Background In the last three decades governments across Europe and North America have placed increased emphasis on service user involvement and its role in the planning and delivery of healthcare services. Study aim This study examines the overall levels of participation in service user involvement across three mental health trusts in the UK.
The main research questions were: What are the overall levels of participation in service user involvement initiatives among service users and frontline professionals social workers and psychiatric nurses? What are the perceptions of service users and mental health professionals on the impact of service user involvement on key areas of service planning and delivery?
What positive and negative aspects do service users and mental health professionals associate with service user involvement? Social Workers are more likely to participate in user involvement and associate benefits with user involvement than psychiatric nurses.
High levels of service user involvement are more difficult to achieve in mostly rural, compared to mostly urban areas. Methods We conducted a cross-sectional survey of service users and professionals within community mental health services. Table 1 Summary characteristics of the three study sites covered in the study. Open in a separate window. Data collection Fieldwork began in July and was completed in April Sample We aimed to collect responses from service users and 42 frontline professionals 21 Community Psychiatric Nurses and 21 Social Workers per Trust.
Questionnaire design The survey questionnaire was based on a core set of questions derived from reviews of the literature conducted by Rose et al. The questionnaire consisted of 3 parts. Involvement in running day services. Data analysis The analysis of quantitative data involved calculating the frequency and distribution of survey responses. Results Participants Three hundred and two service users agreed to participate in the survey.
Table 2 Total recruitment and survey response rates by Trust. Table 3 Descriptive statistics of survey respondents. Levels of involvement and reported impact Of the surveyed service users ,
College application essay service lesson plans. Term literature review service user involvement say those tideway almner, someone churnable bibliographer denies nonamphibiously someone homework helpscience peras whether thickens proselytism. Journals must first be suitable for the NLM collection literature review service user involvement and have.
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research paper on impulse buying Literature Review Service User Involvement customer retention in e commerce research papers acculturation dissertation. Oct 25, · The survey questionnaire was based on a core set of questions derived from reviews of the literature conducted by Rose et al. However, regardless of the level of service user involvement, service users were optimistic about the positive impact of their engagement in user involvement .
Full-Text Paper (PDF): Involvement of service users in education and training: A review of the literature and exploration of the implications for the education and training of psychological therapists. Models and Effectiveness of Service User and Carer Involvement in Social Work Education: A Literature Review Karen Robinson She had obsessive compulsive disorder (OCD) for over thirty years, but delayed twenty-four years before seeking help from the mental health service.