A new way of working in Irish mental health: service user and family member engagement in the design and delivery of mental health services

摘要

Are you part of a ‘new way of working’ already yielding outcome or still in pilot stages? Background : Latterly, there has been an increasing focus by the mental health services in Ireland on working actively with service users, family members and carers as highlighted in various Irish national mental health policy documents. The purpose of such working is seen by health commentators as the way that the views and experiences of service users, family members and carers can be made central to the design and delivery of services. Taking into account the fact that the involvement of users of services has not traditionally been a feature of the production of mental health services, embarking on this journey was seen as a ‘new way of working’. But how actually to ‘do’ that new way of working? How to create a roadmap which would enable that journey to be undertaken? In August 2014, the Mental Health Division of the Irish Health Service Executive (HSE) established a Reference Group to make recommendations on engagement structures. The primary task of the Group, composed of service users and family members and facilitated by members of the Mental Health Division, was to propose mechanisms for promoting widespread and regular, structured consultation with service users and supporters about HSE Mental Health Services locally and nationally. The principal recommendations were about : The role of the Head of Mental Health Engagement as a member of the National Management Team Mental Health Division The role of the nine Area Leads of Mental Health Engagement as members of the Community Health Organisation (CHO) Area Mental Health Management Teams Structures and mechanisms for consultation and feedback through Local and Area Fora Capacity building to support the engagement mechanisms and roles. On receipt of the report, the Mental Health Division of the HSE accepted the recommendations – seen as an exemplar of co-production - in full and began implementing them. Progress to date : The new position of Head of Mental Health Engagement - who was required to be a person with lived experience of mental health challenges or a supporter of such a person - was created. The post was filled in Spring 2016 to oversee the rolling out of the Reference Group Recommendations, to build on the interim central structure and to be a full member of the Senior Management Team at the HSE Mental Health Division. In turn, in Autumn 2016, the process to recruit the Area Leads – who had to demonstrate similar personal experience to that of the Head – began and these managers are likely to be in post in Spring, 2017. They will, then, roll out the local and area representative structures in line with the recommendations of the Reference Group. A ‘new way of working’ : The structures, when fully operational, should generate a two way flow of information and action between service users, supporters and service providers, if the evidence of the research and the aspirations of those involved in this process are borne out and fulfilled.