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      Growing recognition of the importance of service user involvement in mental health service planning and evaluation

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          Abstract

          Service user involvement in the planning and provision of mental health services has been growing over the last two decades, especially in countries and areas where institutional service provision has been changed to a community-orientated model of care. However, the material involvement of service users in mental health research is still in its infancy. The aim of this paper is to attempt to place these developments in a conceptual context, to summarise the ethics-based and evidence-based reasons why it has to be considered as necessary, and to illustrate some of the emerging evidence which shows the advantages to be gained from it. In particular the results of recent studies are briefly reported, showing that outcomes data rated by service users in some cases are more important than those rated by staff. The reduction in patient-ratedunmet needsin the social domain was the strongest predictor of an increase in subjective quality of life. The importance of including service user preferences within the content of the research questions is exemplified by the results of a recent study that showed that joint crisis plans can significantly reduce the use of compulsory admission during crises and by a review that demonstrated that the use of an explicit service user perspective produced distinctive insights into the long-term effects of Electro-Convulsive Therapy (ECT).

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          Developing the theoretical basis for service user/survivor-led research and equal involvement in research

          Summary Aims and methods — This article, written from a service user/survivor perspective, explores a hypothesis which seeks to offer a more systematic basis for the full and equal involvement of mental health service users/survivors in both the research process and research structures more generally. The hypothesis challenges traditional emphasis on positivist assumptions about the priority of values of ‘distance’, ‘neutrality’ and ‘objectivity’ (which it argues discriminate against service users and their experiential knowledge). It explores instead the idea that ‘the shorter the distance between direct experience and its interpretation, then the less likely resulting knowledge is to be inaccurate, unreliable and distorted. Results and conclusions — The proposal discusses ways in which such (objective and subjective) distance may be reduced, to improve the quality of research, to enable more equal involvement of service users and their direct experience and to make it possible for non-service user researchers to work alongside service users on more equal terms. Declaration of Interest : Peter Beresford is Professor of Social Policy at Brunei University and Chair of Shaping Our Lives, the national independent user controlled organisation which receives its core funding from the UK Department of Health. No financial support from pharmaceutical or other commercial companies has been received by the author over the last two years. Funding has been gained from governmental and non-governmenatal funding agencies.
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            User/consumer involvement in mental health service delivery

            The involvement of mental health service users in service delivery is a new and growing phenomenon. Such involvement is complex, given the history of paternalism in the mental health system, the power differential between service providers and service users, and the very differing views each group holds on multiple issues. Unless such differences are addressed, there can be no meaningful involvement. Service user involvement needs to apply to all aspects of the service delivery system, including professional training, service design, delivery, evaluation, and research. User/survivors, and their organizations, have developed a body of experience and knowledge that needs to be recognized and respected. Unless there are multiple opportunities for ongoing and open dialogue on these many difficult issues, real user involvement will not occur.
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              Deliberate self-injury. A consumer-therapist co-run group. A choice or a necessity?

              This aim of this paper is to discuss a consumer-therapist co-run pilot group on self-injury held at an American college. Deliberate self-injury has come to be a common phenomenon in schools and colleges. However the treatment and understanding of self-injury still remains a challenge. Most people who self-injure remain hidden in society and do not seek therapy, due to the shame-filled stereotypes and misconceptions that surround self-injury. Group therapy has been discussed as ineffective by many in the mental health field while individual treatment has been controversial for decades.
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                Author and article information

                Journal
                applab
                Epidemiologia e Psichiatria Sociale
                Epidemiol Psichiatr Soc
                Cambridge University Press (CUP)
                1121-189X
                2038-1816
                March 2005
                October 2011
                : 14
                : 01
                : 1-3
                Article
                10.1017/S1121189X00001858
                a70adfe8-906c-45fd-a1a1-363265dc4bcb
                © 2005
                History

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