The Role of the Consumer in the Leadership and Management of Mental Health Services

Abstract

Both Australia and New Zealand have significant policy directives in relation to consumer involvement in mental health services. The actual realization of consumer involvement within the mental health sector is extremely variable and the extent of genuine participation highly questionable, particularly in regard to leadership and management roles. It is important that the rationale for consumer involvement is continually highlighted and understood by all mental health professionals, including psychiatrists, so as to discourage the practice of including consumers solely for the sake of adhering to political policies. The attitudes of health professionals have been identified as having the most significant impact on consumer involvement. It is questionable whether the critical contribution of consumer involvement in mental health services should remain dependent on the attitudes of non-consumers within the sector. In New Zealand, a paradigm shift is occurring with consumer involvement moving from a construct of 'participation' to one of 'leadership'. Psychiatrists can, and should, play a significant role in advocating for the development of mental health services in directions which support and promote consumer involvement at all levels.

‘Things you can't learn from books’: Teaching recovery from a lived experience perspective

“…This approach to teaching also provides an opportunity to restore the inherent consumer‐driven nature of recovery. Recovery concepts were developed by the consumer movement, contradicting the medically‐held belief that mental illness is unremitting (Anthony ; Mead & Copeland ; Ning ) and it must be ‘the lived experience of those that have triumphed and struggled over mental illness/distress’ (Glover ; p. 179) that continues to inform and direct the ongoing implementation and understanding of recovery (Gordon ).…”

Barriers to patient involvement in health service planning and evaluation: An exploratory study

“…Secondly, patient involvement in service planning or evaluation may be restricted by health professional reluctance to establish a ''dictatorship of the uninformed'' [5,31]. For example, interviews with clinicians and managers revealed negative attitudes to patient involvement in mental health service planning both in the United Kingdom and Australia [32,33]. A third factor possibly limiting patient involvement may be a lack of guidance.…”

Continuing challenges for the mental health consumer workforce: A role for mental health nurses?

“…Given these difficulties, a further concern is the emotional well‐being of the consumer workforce that struggles with or against these conditions on a daily basis (Bennetts 2009). Furthermore, the contributions that the consumer workforce makes to service users, especially in improving their quality of care and treatment, and the mental health system at large, are very important (Gordon 2005).…”

“…As consumer‐based information gleaned over the last 10 years or so in a range of countries reiterates overlapping implementation barriers, it is reasonable to declare that there is a policy practice gap, whereby policy is acted upon to the degree that is required, but a whole‐hearted fulfilment of the spirit and meaning of policy intentions has not always been achieved (Gordon 2005; O'Hagan 2009). According to Bennetts (2009, p. 4), there is a ‘need for a renewed commitment to consumer workforce development in practice’ and the development of a range of approaches.…”

“…If more than 15 years of policy guidelines has not achieved the intended service user outcomes, then it is logical to consider more radical approaches. To fully realize the ‘considerable benefits that result from effective consumer involvement’, a shift in the paradigm ‘from consumer “participation” to consumer “leadership” ’ is likely to be more successful (Gordon 2005, p. 365). Policy directives mandating a system change from participation to leadership might also become terminology without substance, and also, the level of preparedness of survivor cohorts might not yet be adequate, given contemporary evidence from consumer workers.…”