Carers and co-production: enabling expertise through experience?
DOI | https://doi.org/10.1108/MHRJ-05-2014-0016 |
Published date | 14 December 2015 |
Date | 14 December 2015 |
Pages | 232-241 |
Author | Eleanor Bradley |
Subject Matter | Health & social care,Mental health |
Carers and co-production: enabling
expertise through experience?
Eleanor Bradley
Eleanor Bradley is Professor of
Health Psychology at Institute
of Health and Society,
University of Worcester,
Worcester, UK.
Abstract
Purpose –The purpose of this paper is to provide a brief overview of the literature to date which has focused
on co-production within mental healthcare in the UK, including service user and carer involvement and
collaboration.
Design/methodology/approach –The paper presents key outcomes from studies which have explicitly
attempted to introduce co-produced care in addition to specific tools designed to encourage co-production
within mental health services. The paper debates the cultural and ideological shift required for staff, service
users and family members to undertake co-produced care and outlines challenges ahead with respect to
service redesign and new roles in practice.
Findings –Informal carers (family and friends) are recognised as a fundamental resource for mental health
service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited
by mental health professionals or taken into account during decision making. This issue is considered
alongside new policy recommendations which advocate the development of co-produced services
and care.
Research limitations/implications –Despitethe launch of a number of initiatives designed to build on peer
experience and support, there has been a lack of attention on the differing dynamic which remains evident
between healthcare professionals and people using mental health services. Co-production sheds a light on
the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer
recovery workers across England, there has been little research or service development designed to focus
explicitly on this particular dynamic.
Practical implications –Despite these challenges, coproduction in mental healthcare represents
a real opportunity for the skills and experience of family members t o be taken into account and could
provideamechanismtoachievethe“triangle of care”with input, recognition and respect given to all
(service users, carers, professionals) whose lives are touched by mental distress. However, lack of
attention in relation to carer perspectives, expertise and potential involvement could undermine the
potential for coproduction toact as a vehicle to encourage person-centred care which accounts for social
in addition to clinical factors.
Social implications –The families of people with severe and enduring mental illness assume a major
responsibility for the provision of care and support to their relatives over extended time periods (Rose et al.,
2004). Involving carers in discussions about care planning could help to provide a wider picture about the
impact of mental health difficulties, beyond symptom reduction. The “co-production of care”reflects a desire
to work meaningfully and fully with service users and carers. However, to date, little work has been
undertaken in order to coproduce services through the “triangle of care”with carers bringing their own skills,
resources and expertise.
Originality/value –This paper debates the current involvement of carers across mental healthcare
and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and
satisfaction with mental healthcare. The critique of current work highlights the danger of increasing
expectations on service providers to undertake work aligned to key initiatives (shared decision-making,
person-centred care, co-production), that have common underpinning principles but, in the absence
of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle
of care”.
Keywords UK, Mental health, Carers, Co-production, Person-centred care, Shared decision –making
Paper type Literature review
Received 18 May 2014
Revised 25 February 2015
20 September 2015
Accepted 21 September 2015
PAGE232
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MENTALHEALTH REVIEW JOURNAL
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VOL. 20 NO. 4 2015, pp. 232-241, © Emerald Group Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-05-2014-0016
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