An occupational perspective on user involvement in mental health day services

Abstract

This participatory action research project enabled service users to influence the modernisation of local mental health day services. The modernisation programme was based on principles of social inclusion, and there were limited understandings of how it could be applied locally. Interpretations of policy gave priority to the relocation of services and facilitating individual recovery. An occupational perspective informed the design, implementation and analysis, emphasising what people chose to do. Critical ethnography informed the role of the researcher. Service user involvement was understood as a democratic process, drawing on direct experience for service development. A forum, established for four years, worked on and supported three research strands, focused on social networking. Service users captured their use of a social lounge using photography in Strand A. In Strand B a checklist was used to investigate social activities. Userled social groups were explored in Strand C through individual interviews. All the findings were systematically analysed and service users were involved in this for Strands A and B. The findings of this research emphasised the importance of social networking within the day services. Strand A indicated the benefits of a safe space, before getting involved and moving on. The final report from this strand led to ongoing funding being allocated for a safe space. For Strand B many social and recreational activities were identified by service users. Stigma was recognised as an ongoing barrier to sustained inclusion. A poster was designed and displayed locally to share the findings. Themes from Strand C demonstrated that user-led groups required active collaboration with mental health services to survive and thrive. A final stage of analysis aimed to uncover the details of taking an occupational perspective. The findings indicated that varied occupational forms involved different service users in different ways, enabling more people to participate. Making the functions of the different events explicit was important for negotiating participation. Meanings were expressed in shared and individual reflection as the research unfolded. Understanding and attending to these aspects facilitated meaningful service user involvement in this research, enabling many people to influence the development of the services they received.