Beyond policy: consumer and carer participation through the lens of public sector mental health managers

Abstract

Contemporary literature on participation indicates that Australian Federal and State governments and mental health consumers and carers, expect mental health services to improve participation practices. This study sought to fill a research gap by exploring the perspectives of Queensland public sector executive level mental health managers with responsibility for implementing national participation standards.Drawing on theoretical ideas of participation, recovery and social citizenship, the study aim and objective was to identify and analyse the knowledge, attitudes, and practices of mental health managers in relation to consumer and carer participation. A qualitative research design using an interpretative approach was applied. The researcher adopted an insider/outsider/in-betweener researcher position based on her lived experience as a carer, a social work mental health advocate and a manager in a public mental health service. Twenty-three executive level mental health managers across nine public mental health services were interviewed. The study findings showed that numerous participation challenges exist for mental health managers including, working within a neo-liberal context of cost efficiency and effectiveness, competing work priorities, staff negative attitudes towards participation, tensions among stakeholders with different ideas about participation and, managing a growing consumer and carer workforce. Despite these challenges, managers in this study were committed to participation. Managers considered that growth in the consumer and carer workforce was evidence of national participation standards being met but that participation is a complex space that is 'easier said than done'. Findings highlighted the need to strengthen participation through building human connections and relationships among consumers, carers, and mental health professionals and, by fostering mutual respect for lived experience and professional expertise. Findings also highlighted the need to increase support for the consumer and carer workforce and, that while the emphasis has been on growing consumer participation, there is a need to foster and grow family and carer participation.