From service user to VIP: what's in a name?
| Published date | 01 September 2008 |
| Date | 01 September 2008 |
| DOI | https://doi.org/10.1108/17556228200800021 |
| Pages | 53-54 |
| Author | Marjorie Lloyd |
| Subject Matter | Health & social care |
53
From service user to VIP:
what’s in a name?
Marjorie Lloyd
School of Health, Social Care, Sport and Exercise Science, North East Wales Institute of Higher Education
The Journal of Mental Health Training, Education and Practice Volume 3 Issue 3 September 2008 © Pavilion Journals (Brighton) Ltd
Abstract
Service user involvement is a growing and
important trend in the whole of health and social
care and yet when asked, it is difficult to define.
Simply inviting service users and carers along to
meetings can lead to tokenism and a tick box
mentality towards user and carer involvement. This
article argues that perhaps the term service user
should change to something that reflects a greater
understanding of the process. It is argued that
people should not only be involved but also valued
for their unique contribution, on a more equal
footing with professionals.
Key words
service users; involvement; participation;
empowerment; tokenism
‘A name means an object. The object is its meaning’
Wittgenstein (1918)
Within the United Kingdom, the name ‘service user’ is
frequently used to describe the role of someone within the
health and social services who is willing to become an
active participant in the service. In addition, it is now a
legal requirement to develop and respond to local
involvement networks (LINks) under part 14 of the Local
Government and Public Health Act (2007). Service users,
therefore, should be valued as people who have a wide
experience of the service that differs from the experience
of the people who provide the service. It should also be
recognised that doctors, nurses, social workers and other
care staff do not have the same experience unless they
have been in receipt of the same service themselves as a
service user. However, the ongoing debate around who is
or who is not a service user is important but not nearly as
important as the name given to the role. Most societies
develop names for people and their work that will describe
who they are or what they do and often when introducing
yourself to a stranger it is one of the first things that you
will say. However, introducing yourself as a service user
(especially in mental health) could be detrimental to your
credibility if you are in a room full of professional people
or ‘suits’ as they were re-named at a recent conference on
service user involvement in mental health.
Many people, including service users and professionals
have said they would prefer not to use the name ‘service
user’ and a number of alternatives are in place across the
world from patient, citizen, consumer, survivor or
participant but none are really adequate in describing the
role or experience of people on the receiving end of health
and social care services. It could be argued therefore that
whatever name is in use, it needs to encompass the
following concepts that people, especially within the
mental health services, regard as important.
•First, does the name denote a powerbase that is
identifiable from its usage whilst ignoring the unique
contribution of the person? Some people oppose
being called patients because of the powerbase it
invests in the wisdom of the doctor (Foucault 1975).
•Second, does the name identify the diversity of the
person using the service? This is a real problem as
token patients or service users are asked to attend
meetings with a room full of ‘suits’. As Peter Beresford
(2007) suggests in his online web log, ‘They have ended
up being another manifestation of the powers that be,
rather than a counter to them’.
•Third, does the name identify the value of the
contribution that the service user makes as unique
expert in their own care? For example, survivors of
mental illness value the experience that it has given
them of themselves but not always the experience of
being involved or not, in achieving their own recovery.
One could argue, based upon the above points, that
‘service user’ is not an appropriate name because it does
not devolve power or respect to the people who use
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