Implementing co-production in mental health organizations

Published date24 October 2019
Date24 October 2019
DOIhttps://doi.org/10.1108/JMHTEP-01-2019-0008
Pages480-492
AuthorEleonora Gheduzzi,Cristina Masella,Federica Segato
Subject MatterHealth & social care,Mental health,Mental health education
Implementing co-production in mental
health organizations
Eleonora Gheduzzi, Cristina Masella and Federica Segato
Abstract
Purpose The purpose of this paper is to study four cases of the adoption of co-production and compare
them according to the type of user involvement, contextual factors and the organizational structure.
Design/methodology/approach In total, 30 interviews were conducted in four mental health
organizations which are implementing co-production in the North of Italy. Interviews were conducted with
clinicians, nurses, patients and family members. The data collected was triangulated with further sources and
official documents of organizations. The results have been compared by means of a validated international
framework (IAP2) regarding the contextual factors and the level of co-production adopted.
Findings The adoption of co-production in the four cases differs by the activities implemented and how
organizations involve informal actors. It seems to be influenced by the contextual factors specific to each
organization: power, professionalsopinions and leadership. Organizations whose practitioners and leaders
are willing to distribute their power and value informal actorsopinions seem to facilitate the systematic
involvement of users. Overall, the results highlight the importance of considering contextual factors when
evaluating and describing co-production activities.
Originality/value This paper contributes to describing how mental health organizations are implementing
co-production. It examines the influence of contextual factors on the type of co-production adopted.
Keywords Organizational change, Mental health, Co-production, Context, Public health,
Patient engagement
Paper type Research paper
Introduction
Mental health is one of the priorities of many national healthcare systems of developed countries
(Satinsky et al., 2018). Since 2007, mental disorders have been the second largest worldwide
cause of health loss, with an increasing rate of 12 percent (World Health Organization, 2018b).
Corroborating this scenario, a recent study by the World Health Organization (WHO) estimates
that the most common disorders reduce global productivity by $1 trillion each year (World Health
Organization, 2017).
Currently, mental healthcare services are unable to cope with the increasing demand, widening
the gap between the necessity for further treatments and their supply. It has been estimated that
between 35 and 50 percent of people affected by mental illnesses in developed countries receive
no treatment and the percentage is even higher in developing countries (World Health
Organization, 2018a). Within this context, the Action Plan 20132020, promoted by the WHO,
provides some guidelines in regard to mental health issues. The most innovative suggestion is to
develop comprehensive community-based mental health and social care servicesthat include
formal and informal actors, such as families and non-governmental organizations. This network
aims at improving patientswell-being, adopting a recovery-based approach that enables
patients to play an active role in their recovery journey and to co-produce their care by
collaborating with all the other clinical and informal actors (World Health Organization, 2013).
Community-based services increase the number of resources available in the care pathway,
supporting mental health servicesproviders in addressing patientsdemand.
Received 30 January 2019
Revised 23 June 2019
Accepted 7 August 2019
Eleonora Gheduzzi,
Cristina Masella and
Federica Segato are all based
at the Department of
Management, Economics and
Industrial Engineering,
Politecnico di Milano,
Milano, Italy.
PAGE480
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
VOL. 14 NO. 6 2019, pp.480-492, © Emerald Publishing Limited, ISSN 1755-6228 DOI 10.1108/JMHTEP-01-2019-0008

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