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There has been increasing interest and research attention towards citizenship‐based practices and care within health and social care settings. A framework for implementing citizenship‐based interventions has helped support the participation in society of persons who have experienced major life disruptions. Yet, having ways to measure the impact of citizenship 'in action' within specific socio‐cultural contexts has proved challenging. We report on the development of the Strathclyde Citizenship Measure (SCM) which seeks to establish a psychometrically sound measure of citizenship that is relevant to the Scottish context. We outline the three phases of developing the SCM: (1) item generation, (2) item reduction and piloting, and (3) measure validation. Having generated items for the SCM using concept mapping techniques, we piloted it with 407 participants who completed an online survey of a 60‐item version of the SCM. The aims were to assess the validity of the items and reduce the number of items using principal components analysis for the final measure. This resulted in a 39 item SCM. We then sought to establish the psychometric properties of this shorter version of the SCM through testing its reliability, convergent, concurrent and discriminant validity. The 39 item SCM was administered online to 280 Scottish residents along with additional measures including the Warwick‐Edinburgh Mental Well‐being Scale (WEMWBS), the Depression, Anxiety and Stress Scale (DASS21), the Sense of Belonging Instrument (SOBI‐A); the Big Five Personality Inventory (Shortened Version; BFI‐10) and the Personal Social Capital Scale (PSCS‐16). The factor structure and dimensionality of the SCM was examined using exploratory factor analysis and it was found to be reliable and valid. This paper explores the potential for the application of the SCM across health and social care settings and identifies future work to develop citizenship tools to facilitate dialogues about citizenship across health and social care practice settings. [ABSTRACT FROM AUTHOR]

Citizenship is gaining currency in health and social care internationally as a way of making sense of the lived experiences of people with major life disruptions who face exclusion, marginalisation and discrimination, but the concept is often contested, poorly defined and understood. This paper charts the development of an empirical model of citizenship within Scotland, UK. A mixed‐method, community‐based participatory research approach using 10 focus groups (n = 77), concept‐mapping exercises (n = 45) and statement clarity and relevant ratings (n = 242) was used to develop a model of citizenship that is grounded in the lived experience of participants, which is absent from current conceptualisations of citizenship. Multidimensional scaling and hierarchical cluster analysis revealed five core domains emerging from our work: 'building relationships', 'autonomy and acceptance', 'access to services and supports', 'shared values and social roles' and 'civic rights and responsibilities' representing the personal meanings of citizenship for participants. We argue that the value of this model is that it is draws upon the personal understandings and experiences of participants who emphasised the 'banal ordinariness' of its core elements. We suggest that the model makes an original contribution by clearly illustrating the practical applicability of citizenship as a concept; thus, enhancing existing theories of citizenship. Our model highlights the interplay between the relational and structural aspects of citizenship and acknowledges the barriers that marginalised groups face in claiming their citizenship rights. It offers a call to action for policy makers and practitioners to set goals that contribute to the social inclusion of those who have experienced major life disruptions. [ABSTRACT FROM AUTHOR]

Citizenship has been promoted within mental health for several decades however, its application in the field of mental health policy and practice is relatively novel. The voices of people who experience mental health problems (MHPs) are often absent in ongoing discourses about citizenship. To explore how adults with experience of MHPs and other life disruptions identify potential barriers to citizenship. A community based participatory research approach was adopted with peer researchers. Six focus groups (N = 40) using semi-structured interviews were conducted, consisting of participants who had experience of MHPs and other life disruption(s) within the last 5 years. The focus groups were audio recorded, transcribed verbatim and analysed in NVIVO using a thematic approach. Three major themes associated with participants lived experiences of barriers to citizenship were identified: 'stigmatisation (internal & external) creates further divide'; 'being socially excluded leads to isolation'; and 'a sense of difference (as perceived by the self and others)'. Those who have experienced major life disruption(s) face multi-level barriers to citizenship. An awareness of such barriers has important implications for mental health research, policy and practice. Citizenship-oriented implementation strategies that aim to address multi-level barriers merit further investigation. [ABSTRACT FROM AUTHOR]

Purpose: People with lived experience of mental health problems (MHPs) are often marginalised and have difficulty achieving community inclusion. Citizenship, a relatively novel concept in mental health, provides a means of understanding what is necessary for marginalised individuals and groups to gain a sense of belonging within their communities. By exploring the "what, why, how and who" of citizenship, the purpose of this paper is to provide a rationale for the inclusion of citizenship as part of a person-centred and holistic mental health strategy. Design/methodology/approach: A community-based participatory research (CBPR) approach, with peer researchers, was adopted to develop a model of citizenship within a Scottish context. The aim of the model is to link the concept of citizenship with specific strategies that systems, agencies and individuals can use within mental health policy and practice to promote greater inclusion and participation. Concept mapping was used as part of a mixed-methods participatory methodology and data were then analysed using multivariate statistical methods of multidimensional scaling and hierarchical cluster analysis. Findings: It is argued that using a CBPR approach, utilising concept mapping, encourages the development of a model of citizenship that is entirely grounded in the perspectives and lived experiences of people with MHPs. The need for adequate resources, preparatory work, training, research management and reflexive practice are key to the success of a CBPR approach with peer researchers. Originality/value: Working with peer researchers and key stakeholder groups is central to a CBPR approach and the implementation of a model of citizenship within mental health policy and practice. Developing a model of citizenship derived specifically from the experiences of people with lived experience is likely to promote their inclusion. It provides a means of challenging the structural deficits and inequalities that cause distress and prevent people with lived experience of MHPs of recovering their citizenship. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the persistent challenges in implementing care management within the context of integration. In addition the appropriateness of the care management model will be considered within the current, personalization focused, health and social care policy landscape. The paper draws upon a recent evaluation of a care management and assessment pilot project within a health and social care partnership in Scotland. Design/methodology/approach – A multi-method approach was adopted, including interviews, vignettes and focus groups, in order to capture data around expectations in relation to the pilot as well as exploring processes and outcomes for those involved. Findings – This paper argues that whilst progress has been made with regard to care management, specific and persistent challenges remain. Professional and organizational boundaries, communication and information sharing remain key challenges. Policy imperatives have shifted the emphasis in community care services towards self-care, co-production and personalization contributing to a lack of clarity over the place of care management within the broader integration agenda. Research limitations/implications – This research was undertaken in one partnership locality in Scotland and as such the findings are related to that particular area. However, the key messages arising from this paper resonate with the broader academic literature on care management and as such are likely to be of interest to a broader audience. Originality/value – This paper brings together integrated working, care management and the developing policy framework of self-care to consider the challenges for care management in this context. [ABSTRACT FROM AUTHOR]