Bringing meaning to user involvement in mental health care planning: a qualitative exploration of service user perspectives

Abstract

Users describe a common model of meaningful involvement in care planning. Their requests, summarized through a 10C framework of care planning involvement, provide clear direction for improving service users satisfaction with care planning and enhancing the culture of services.

Talking about mental health nursing: a qualitative analysis of nurses’ and service users’ accounts

“…The only challenge came from Abby who reported she had seen patients asked about their feelings in a ward round. However, recent research indicates that there is insufficient service user involvement occurring in care planning (Grundy et al, 2016;Simpson et al, 2016b). Findings from my study suggest student participants' views are clear that elements of service user involvement in care planning are not widely evident.…”

“…Whilst there would be occasions when service users may be deemed too unwell to engage in meaningful discussions about their care, there are also too many examples of services users being excluded from these conversations Grundy et al, 2016;Simpson et al, 2016b). I also note Mary's continued use of 'they' which implies othering, a 'them and us' mentality, which perhaps reinforces the sense of a lack of partnership working.…”

“…However, despite increased guidance and legislation promoting user involvement, it is reported that user involvement levels in mental healthcare could be significantly improved (Grundy et al, 2016;Simpson et al, 2016b). Bee et al (2015a) highlight that policy imperatives about involvement remain inconsistently implemented, and can be contested or diluted by more procedural or traditional practices.…”

“…Bee et al (2015aBee et al ( , 2015b reported that user involved care planning was considered difficult to realize in practice, with extremely engrained nursing behaviours sustained through top-down, risk averse cultures which prevent meaningful engagement and are directly opposed to service user notions of hope and recovery. It is reported that service users often feel marginalised in the care planning process and are dissatisfied with care planning involvement (Grundy et al, 2016).…”

“…This partnership working would usually involve discussions about service users' plans for recovery, evidence based interventions, and on-going conversations provided through the context of a therapeutic relationship with the service user. However, recent research indicates that service user partnerships in practice require much improvement (Grundy et al, 2016;Simpson et al, 2016a). Equally, a shift is required in the relationships that mental health nurses have with service users in order to incorporate participation and involvement into people's care (Newman, O'Reilly, Lee, & Kennedy, 2015).…”