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Aim The paper aims to develop a model of translational research in which service user and other stakeholder involvement are central to each phase. Background 'Translational' is the current medical buzzword: translational research has been termed 'bench to bedside' research and promises to fast-track biomedical advances in the service of patient benefit. Models usually conceive of translational research as a 'pipeline' that is divided into phases: the early phase is characterized as the province of basic scientists and laboratory-based clinical researchers; the later phases focus on the implementation, dissemination and diffusion of health applications. If service user involvement is mentioned, it is usually restricted to these later phases. Methods The paper critically reviews existing literature on translational research and medicine. The authors develop a theoretical argument that addresses why a reconceptualization of translational research is required on scientific, ethical and pragmatic grounds. Results The authors reconceptualize the model of translational research as an interlocking loop rather than as a pipeline, one in which service user and other stakeholder involvement feed into each of its elements. The authors demonstrate that for the 'interlocking loop' model of translational research to be materialized in practice will require changes in how health research is structured and organized. Conclusion The authors demonstrate the scientific, ethical and pragmatic benefits of involving service users in every phase of translational research. The authors' reconceptualized model of translational research contributes to theoretical and policy debates regarding both translational research and service user involvement. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this article is to provide a commentary on Harding et al.'s article about the involvement of people with learning disabilities in university teaching and conference presentations. Design/methodology/approach – The article reviews research into communication strengths and needs and into communication partnerships between service users and members of staff with a view to identifying communication barriers to the involvement of people with learning disabilities. Findings – The generally poor communication environments in which people are supported are likely to limit opportunities for involvement. Originality/value – It is suggested that increased involvement is likely to result from increased quality of daily communication. This may best occur as part of general service-wide approaches to improving service quality, such as person-centred active support. [ABSTRACT FROM AUTHOR]

Service user involvement is now a well embedded feature of social work education in the United Kingdom. Whilst many education institutions have fully embraced the involvement of service users in teaching, there is still work to be done in more fully engaging with service users who are seldom heard. This article highlights the opportunities and challenges associated with innovative work being piloted in Northern Ireland where victims and survivors of political conflict are routinely involved in teaching social work students about the impact of conflict on their lives. [ABSTRACT FROM PUBLISHER]

Based on the pre-war, war and post-war experiences of social work and social welfare reform in south-east Europe, particularly the former Yugoslavia, the authors reflect on the reasons for some of the paradoxes regarding the politicisation of social work over the past two decades, given the centrality of political factors in both the conflict and post-conflict environments. The text explores the often neglected history of social work and social welfare in former Yugoslavia prior to the 1990s. It then addresses the dominance of ‘psycho-social’ and medicalised approaches to welfare during the war and, finally, examines the role of international organisations in supporting welfare reform in the post-war period. The latter two periods include examples from the authors’ own practice. Based on these experiences and the available literature, the text emphasises the need for a longer-term engagement in war and post-war communities, based on practices that build alliances between social workers, community activists and service users. [ABSTRACT FROM PUBLISHER]

Accessible summary As more and more service providers working in addictions and mental health services in Ireland are reporting an increase in individuals presenting with dual diagnosis, there is a need for training these professionals. The dual diagnosis training course developed by the authors is the only continuing professional development training course available to these professionals in Ireland., In this paper, we describe the first group of participants' evaluation of the dual diagnosis training course, which was delivered to service providers working with dual diagnosis service users., Participants found the training course to be motivating and valuable to their work practice. Since completing this training course, participants were more confident in working with dual diagnosis service users., Service user involvement, use of various teaching methods and the opportunity for inter-agency networking are important components of inter-professional training courses., Abstract A training course on dual diagnosis was developed within the Irish forensic mental health service, to bridge the gap in the lack of training on dual diagnosis in Ireland. The course was designed for service providers within mental health and addiction services. Twenty participants involving nursing, social work, police and social welfare disciplines attended the first training course. A mixed methodology research design was adapted to describe participants' evaluation of the training course. Data were collected using multiple methods: pre- and post-test, daily evaluation and focus group interviews. Quantitative data were analysed using the spss Version 16.0 and qualitative data were analysed thematically. Findings from the pre- and post-test suggest an increase in participants' knowledge of dual diagnosis and an increase in confidence in conducting groups. Daily evaluation indicates that the course content largely met participants' needs. Finally, three themes emerged from the focus group interview: increased confidence, the training course/teaching methods and personal/organizational challenges. This study implies that service providers within mental health and addiction services benefit from inter-professional, needs and skills based courses incorporating a variety of teaching methods. The way forward for future dual diagnosis training course developments would be working in partnership with service users and carers. [ABSTRACT FROM AUTHOR]

Purpose – In April 2010, Nottinghamshire NHS trust recruited ten peer support workers (PSWs) to pilot the idea of PSWs within the organisation. As the first initiative of its kind the first year involved constant development from everybody involved. The aim of this paper is to provide an insight into this experience from the perspective of the PSWs themselves. Design/methodology/approach – A personal narrative of the first year of peer support is provided by a PSW employed by Nottingham NHS Trust and some of the key lessons learnt are described in terms of the "do's and don'ts" of peer support. Findings – The reality of peer support involves constant questioning, facing dilemmas and challenging situations. Over the first year these were addressed by the peer support team as a whole and solutions were found together. The process is not easy for PSWs, all of whom have had to face situations, care settings and people that have triggered difficult memories and led to reflection on their personal recoveries. The hard work has brought rewards to the team for which they are grateful and which spurs them forward towards the next stage of their journeys. Originality/value – This is a unique personal reflection of the processes involved in developing a peer support relationship. This will be of interest to those planning to implement this process in the NHS or those who hope to work within a peer support team. [ABSTRACT FROM AUTHOR]

Purpose -- This paper seeks to report some of the findings from an evaluation of adult safeguarding in one English local authority. The evaluation was commissioned in the context of concern regarding the number of safeguarding investigations that resulted in inconclusive outcomes. Design/methodology/approach -- All adult social care teams in the local authority were asked to complete a short pro forma about the five most recent adult safeguarding alerts that they had managed to completion. Data collected included: characteristics of the alleged victim and alleged perpetrator; details of the professionals involved; whether or not a safeguarding plan meeting/case conference was held; and the outcome of any investigation. Respondents were also asked to comment on factors that they perceived to have helped or hindered the investigation. Findings -- Findings suggest that a significant number of variables influence the likelihood of cases resulting in a conclusive outcome. These variables included not only the characteristics of alleged victims, but also elements of safeguarding practice -- including inter-agency co-operation, social workers' pre-existing knowledge of the alleged victim, and the convening of safeguarding plan meetings. A failure to actively involve alleged victims in the safeguarding process was also noted. Research limitations/implications -- This is a relatively small sample from a single local authority. Originality/value -- This is the first study to provide qualitative evidence about the factors which influence the success or otherwise of adult safeguarding practice. The findings are likely to be of value to professionals working in adult safeguarding who are seeking to understand "what works" in managing investigations following safeguarding alerts. [ABSTRACT FROM AUTHOR]

One of the most important decisions that is made about people with learning disabilities who receive community-based care concerns the recruitment of their support workers. This article discusses a project in which a group of service users took part in the interview panels during the recruitment of support staff for other clients. It describes the training sessions, results of the interviews and subsequent developments, and presents a selection of staff and service users' views. [ABSTRACT FROM AUTHOR]

Service users express dissatisfaction with inpatient care and their concerns revolve around staff interactions, involvement in treatment decisions, the availability of activities and safety. Traditionally, satisfaction with acute care has been assessed using measures designed by clinicians or academics. To develop a patient-reported outcome measure of perceptions of acute care. An innovative participatory methodology was used to involve services users throughout the research process. A total of 397 participants were recruited for the study. Focus groups of service users were convened to discuss their experiences and views of acute care. Service user researchers constructed a measure from the qualitative data, which was validated by expert panels of service users and tested for its psychometric properties. Views on Inpatient Care (VOICE) is easy to understand and complete and therefore is suitable for use by service users while in hospital. The 19-item measure has good validity and internal and test–retest reliability. Service users who have been compulsorily admitted have significantly worse perceptions of the inpatient environment. A participatory methodology has been used to generate a self-report questionnaire measuring service users' perceptions of acute care. VOICE encompasses the issues that service users consider most important and has strong psychometric properties. [ABSTRACT FROM AUTHOR]

Summary: Service user involvement is a key element within current pre- and post-registration nurse education in the U.K. but achieving this is challenging. Most service user involvement is through classroom visits. Digital stories, film and audio are alternatives but lack the interactivity and development of reflection that can be achieved through face-to-face contact. This report reviews the background to service user involvement in healthcare professional education then provides a reflective account of a novel initiative whereby a spinal-injured patient was involved in creating a digital story around some of his in-hospital experiences and then engaged in online discussions with post-registration nursing (degree) and practice educator (masters) students. These discussions provided a richer experience for the students enabling them to reflect more deeply on how nursing care is delivered and perceived by service users. The report concludes that digital stories can be used with repeated groups to inspire discussion and reflection. Augmenting such digital stories with online discussions with the service user whose story is told helps practitioners develop greater empathy, insight and understanding which are beneficial for improving service delivery and nursing care. [Copyright &y& Elsevier]

Summary: Aim: Recent policy initiatives have identified that service user involvement in the education, design and delivery of mental health services should be more evident. This paper will discuss a methodology that was developed to do this. Method: A small study was designed and undertaken to explore the needs of service users and carers when becoming involved in mental health care. This paper will discuss the methodology that was developed for the study in order to make involvement practices more visible. Findings: A critical conversation or narrative was developed that identified three main themes. Developing relationships with service users and carers that share universal goals whilst respecting diverse needs and encouraging recovery were found to be valued by the participants. Conclusion: The paper will conclude by showing how this methodology can be equally applied in a learning context, relevant for mental health nurse education. [Copyright &y& Elsevier]

Summary: Assessment tools were designed to provide health and social care students with multi-sourced, interprofessional feedback in practice. This includes feedback from service users. Third year medical students at the University of Leeds were given accesses to 4 assessment tools whilst in practice. Completed assessments were then sent to the university where service users and carers worked with university tutors to give further feedback and comment on the overall development of students. Three service users then took part in a focus group and one provided written feedback. Four key themes were identified from the focus group [•] Preparation and support [•] The design of the tools [•] The process of using the tools in practice [•] Feedback We found that the project provided both challenges and rewards for all involved. The service user educators involved were able to bring a different and valuable perspective to formative feedback. The combination of their personal and professional experiences, along with the preparation they had received, helped bridge the gap between service users in practice and university based tutors. The findings from this study went on to inform a review of the assessment tools and revised versions are now being used. [Copyright &y& Elsevier]

Purpose – In spite of the greater prevalence of mental ill-health in people with intellectual disabilities, there has been little work specifically aimed at how this group recognise threats to their mental health and the strategies used to minimise them. This study aims to look at the first stage of development of a guided self-help (GSH) pack called the Self Assessment and INTervention pack (SAINT). Design/methodology/approach – Delphi methods and focus groups were employed to gather opinions from two expert groups: professionals or clinical experts (ranged N=15-33); and service users (n=9), to inform the contents of the SAINT. The Delphi was conducted by e-mail. Results from each round were shared between the two groups to develop a consensus. Findings – Retention rates for clinical experts were 45.45 per cent, during the Delphi and 100 per cent for the service user experts in the focus groups. Both groups were able to reach a consensus of the items that would make up the SAINT. Delphi methods combined with focus groups were able generate the contents of the SAINT and demonstrated versatility in this dual approach by being able to gain a consensus from both groups. Research limitations/implications – There is no consensus as to how many people are ideal for a Delphi. Although the final number in round 3 was low, it can be argued that those remaining had most interest in the subject. Practical implications – The aim is to produce and pilot the SAINT, a GSH package for people with intellectual disabilities, following reliability and validity testing. Social implications – Currently GSH is widely used for mild depression in Primary Care and other disorders such as mild anxiety, obsessive compulsive disorder, and other related conditions. However, there are no specific GSH packages for people with intellectual disabilities. Currently the GSH tools that are available are not designed for people with cognitive impairments and do not reflect the lifestyles of many people with intellectual disabilities. Originality/value – This paper should be of value to anyone with an interest in supporting people with intellectual disabilities to recognise and manage specific symptoms or feelings that threaten the person's mental well being. [ABSTRACT FROM AUTHOR]

Survivor-controlled research in the field of mental health can be perceived as the most extended development of participatory research. This is not only because it does away with the role of research subjects, but because the experiential knowledge (as opposed to clinical) acquires a central role throughout the whole research process-from the design to the analysis and the interpretation of outcomes stages. The first part of this article provides some background information about the context and development of user/survivor-controlled research in the UK. In the second part, the discussion focuses on the first two German studies which apply this research methodology in the field of psychiatry. Both studies are used as examples of the approach, which favors closeness to the subject as opposed to "scientific distance." The overall objective of this paper is to outline the general achievements and challenges of survivor-controlled research. Arguing for the value of this research approach I hope to demonstrate the ways in which it raises fundamental issues related to conventional knowledge production and challenges the nature of what counts as psychiatric evidence. [ABSTRACT FROM AUTHOR]

Purpose - People who self-injure present a serious concern for many healthcare providers and no more so than for those working in the female prison estate. Despite the prevalence of self-injury and recent policy highlighting the need for staff training, misunderstanding and misinterpretation of self-injury is rife within the healthcare professions often demonstrated by poor levels of service and care. This paper seeks to describe the development of a self-injury training package for prison staff, through service user involvement, in order to address such deficits in care.Design/methodology/approach - A participatory mixed methodological design engaged both staff and women in prison. Women offenders were involved in the development of training drawing upon their unique experiential expertise.Findings - In total, 43 per cent of staff working directly with women recognised the need to develop their understanding of, and skills to manage, self-injury. Key messages women wanted to convey to staff included how to communicate effectively and demonstrate empathy.Research limitations/implications - Service user involvement in the training of staff is achievable in a prison environment. Women and prison staff identify the need for on-going training in relation to the management of self-injury. Limitations of the sampling strategies are acknowledged but not considered significant.Practical implications - The authors assert that service user involvement is crucial in the development of meaningful training in the management of self-injury.Social implications - The involvement of service users in prison staff training empowers those involved and may foster improved prisoner-staff relationships.Originality/value - Service user involvement in prison staff training has no precedent in the UK. [ABSTRACT FROM AUTHOR]

Background: For two decades, mental health services in Norway have focused on service user involvement. Despite this, there is little knowledge about how inpatient mental health services have promoted user involvement.Aim: To examine service providers’ reports of service user involvement at the individual and departmental levels in Norwegian community mental health centres (CMHCs).Methods: One hundred and eighty six (186) inpatient service providers in five CMHCs filled out a questionnaire.Results: Confirmatory factor analysis showed that service provider perceptions and awareness of service user involvement can be measured by three subscales: organizational user involvement; patient collaboration; and assisted patient involvement. Little user involvement was reported at the departmental level. Providers more often reported user involvement at the individual level. Providers in two of the CMHCs reported a somewhat higher degree of departmental-level user involvement. There were no significant differences across gender, age, leader position, profession and job tenure, though evening/night shift workers reported a lesser degree of user involvement.Conclusion: The results suggest that user involvement at the departmental level needs to be addressed in future efforts to promote user involvement in CMHCs. [ABSTRACT FROM PUBLISHER]

As service user involvement in health and social care research has become more firmly embedded in health policies, both in the UK and internationally, there is increasing interest in evaluating its potential benefits and outcomes. Impact studies have highlighted a range of different types of service user involvement, using diverse research methods, within various research topics and involving different stakeholders. Potential benefits to research, researchers and the service users actively involved in research have been identified, along with the possibility of some negative consequences. Many impact studies have been criticized for being based on informal retrospective accounts of researchers and service users working together. Few have been underpinned by conceptual models, and there is a paucity of detailed accounts of the process of involvement that would enable replication. This paper reports an account of a prospective, qualitative exploration of service user involvement within a study, where the aims of the evaluation were agreed beforehand. Reflective discussions about the process and progress of service user involvement at different stages of the study were recorded, transcribed and analysed. The qualitative analysis identified perceived benefits to research, researchers and service user researchers that endorsed previous findings. The analysis also highlighted subjective and interpersonal aspects of service user involvement that have seldom been reported. This evaluation demonstrates the benefits of allowing time for structured reflection and adds to the understanding of the process and meaning of service user involvement in research. [ABSTRACT FROM AUTHOR]

Aim This paper focuses on stakeholders' active involvement at key stages of the research as members of a Stakeholder Action Group (SAG), particularly in the context of lay stakeholder involvement. Some challenges that can arise and wider issues (e.g. empowerment, the impact of user involvement) are identified and explored within the literature on service user involvement in health care research, reflecting on the implications for researchers. Background In the DEPICTED study, lay and professional stakeholders were actively involved in developing a complex research intervention. Lay stakeholders comprised teenage and adult patients with diabetes, parents and patient organization representatives. Professional stakeholders were from a range of disciplines. Methods Three 1-day research meetings were attended by 13-17 lay stakeholders and 10-11 professional stakeholders (plus researchers). The SAG was responsible for reviewing evidence, advising on developing ideas for the research intervention and guiding plans for evaluation of the intervention in a subsequent trial. Formal evaluations were completed by stakeholders following each SAG meeting. Results Throughout the first (developmental) stage of this two-stage study, lay and professional stakeholders participated or were actively involved in activities that provided data to inform the research intervention. Lay stakeholders identified the need for and contributed to the design of a patient-held tool, strongly influenced the detailed design and content of the research intervention and outcome questionnaire, thus making a major contribution to the trial design. Conclusion Stakeholders, including teenagers, can be actively involved in designing a research intervention and impact significantly on study outcomes. [ABSTRACT FROM AUTHOR]

Service user involvement in health and social care is a key policy driver in the UK. In cancer care it is central to developing services which are effective, responsive and accessible to patients. Cancer network partnership groups are set up to enable joint working between service users and health care professionals and to drive service improvements. The aim of this study was to explore the influence of the cancer network partnership groups' service user involvement activities on cancer care. This was a qualitative study involving documentary analysis and in-depth case studies of a sample of partnership groups. Five partnership groups were purposively selected as case studies from Macmillan regions across the UK; documents were collated from a further five groups. Forty people, including core group members and key stakeholders in cancer services, were interviewed. The evidence from this study suggests that cancer network partnership groups are at their most influential at 'grass roots' level - contributing to patient information resources, enhancing access to services, and improving care environments. While such improvements are undoubtedly important to patients, the groups' aim is to influence strategic changes, for example in cancer care commissioning or macro-level policy decision-making. The evolution of open, participatory relationships between service users and professionals, and recognition of the value of experiential knowledge are seen as key factors in influencing cancer care. The provision of dedicated resources to strengthen service user involvement activities is also vital. [ABSTRACT FROM AUTHOR]

Background: Modern mental health strategies emphasize the necessity of user participation, but only a few studies examine how user involvement can be promoted effectively. Aim: To study the possible effect of an intervention program designed to (1) increase attention to user involvement and (2) increase user involvement at the inpatient departmental level. Methods: The study has a quasi-experimental design, involving inpatient departments in five Norwegian Community Mental Health Centers (CMHCs). Two CMHCs received the intervention, and were compared with three CMHCs that did not. The impact of the intervention was assessed with the Service User Involvement in Mental Health Scale (SUIM), a selection of items from the Consumer Participation Questionnaire (CPQ) and the Psychiatric Inpatient Experience Questionnaire (PIPEQ). One hundred and twenty-three service providers, 51 in the intervention group and 72 in the comparison group, and 47 inpatients took part in the study. Results: Providers in the intervention group reported higher mean scores at follow-up for the variables of organizational user involvement, patient collaboration, and carer involvement than the comparison group. The intervention program was not associated with inpatients reporting more satisfaction with care. Conclusion: An intervention program can be useful in increasing attention to service user involvement in inpatient mental health services. [ABSTRACT FROM AUTHOR]

Summary: In this article we describe and critically analyse the process of developing an assessment tool designed by users of mental health services to assess student nurses in practice. The developmental process raised a number of complex and unexpected issues. The findings suggest that rather than “assess” student nurses in practice, service users should have a role in reviewing student''s practice. Whilst there was a consensus amongst stake-holders that engaging in this feedback process is beneficial to both the student and service user, it is the manner in which it is sought which requires further investigation. [Copyright &y& Elsevier]

Aim. This paper is a report of a study conducted to compare service users', nursing students' and Registered Nurses' evaluations of the usability of a patient education website intended for individuals with severe mental health problems. Background. There is an obvious need for reliable mental health information on the Internet. When evaluating the usability of Internet-based patient education methods, the opinions of all parties need to be ascertained. Methods. An explorative descriptive design was used. Twenty-one service users, 20 nursing students and 35 Registered Nurses were recruited for the study in 2003 and 2004. Data were collected using a self-developed questionnaire on the content, structure and visual appearance of the website. Results. Service users had positive attitudes towards computer and Internet use but they needed support when using the computer and Internet. According to the evaluations, the content, structure and visual appearance of the website were good and it could be adopted for clinical practise after minor revisions. There were some differences in the evaluations between participant groups. Nurses were the most critical group, and the service user group was the most satisfied, although they were less experienced with using both computers and the Internet. Conclusion. It is especially important to include service users' evaluations at the early stages of the development process of Web-based patient education systems. It is possible to produce an information technology-based patient education system for individuals with severe mental health problems. Nurses working in psychiatric services need to pay more attention to supporting service users in computer and Internet use. [ABSTRACT FROM AUTHOR]

In Britain, the last two decades have seen a considerable increase in focus on service users' involvement in the provision of services that directly affect them, particularly where service users originate from a hard to reach population such as drug users. While the National Treatment Agency and drug and alcohol action teams often extol the virtues of the involvement of drug users in their service provision, participation of this type does not come without problems of its own. Experience of drug user involvement in service provision is much more established in Europe and this article seeks to utilise European examples in illustrating the potential pitfalls of such a strategy. Case studies are examined from three countries: the Netherlands, where drug policy is relatively liberal and drug user groups have been established since the 1970s; Denmark, where drug policy is fairly well balanced between repression and tolerance and drug user groups have been established since the 1990s; and Sweden, where drug policy is relatively repressive and drug user groups are only just emerging. Salient points from these case studies are then used to form the discussion, relating European experiences to the situation in Britain. [ABSTRACT FROM AUTHOR]

In the UK, researchers across the health professions are increasingly being encouraged by policymakers and research commissioners to ‘involve’ service users in research. A recent review shows there is some evidence that involving patients, carers, relatives, social or community groups directly and actively as part of the research process can improve the conduct of research studies and the impact of the findings. Yet, little is known about how involvement is played out within research studies and there is a need for more critical and consistent assessment of what constitutes quality involvement. The overall purpose of this paper is to support learning about quality service user involvement in health care research. The aim is to provide service users and researchers with a structured and consistent way to reflect and report on their experiences. A range of philosophical and social theories of power and empowerment were reviewed and synthesized to create a model of quality involvement. The analysis encompassed both service user factors (what a person feels able to do, whether they feel their potential is being fulfilled and their sense of being valued) alongside research factors (research relationships, ways of doing research, research structures). A model is presented (Quality Involvement Framework), which contributes theoretically informed perspectives about the meaning and assessment of quality service user involvement in research. The model is developed as a practical measure (a Quality Involvement Questionnaire) for researchers and service users to be more reflective about the constraints and possibilities of involvement. The tools presented here could help research teams to examine personal factors and the research contexts that influence the nature and quality of service user involvement in research. They may also help to identify reoccurring issues about quality which could inform future policy, practice and research. [ABSTRACT FROM AUTHOR]

Predecessor research suggests that anything from 37% to 53% of hospitalized service users are readmitted within 12 months of discharge. This cycle of frequent admissions represents a serious challenge to clinicians and service users alike. Critically, much of the research in this field has relied exclusively on professional attributions for readmission with little acknowledgement of service user or patient viewpoints. This paper reports on a phenomenological study which used multiple data collection approaches to explore service user and clinician attributions for frequent hospitalization to an identified psychiatric unit over a 24-month index period. Methods included a retrospective review of multi-professional case notes, clinician and service user semi-structured interviews, and focus groups. Service users cited ‘situational circumstances’, rather than medically accepted relapse indicators such as ‘non-adherence with prescribed medication’ as the main reasons for readmission. Notable disagreement existed between clinician and service user data sources. Hospitalization is a complex, individually determined experience. Clinicians and service users have differing perspectives on the causal risk factors and this presents complications for those developing relapse prevention strategies. However, a shared appreciation of the multiple realities paves the way for the development of a conceptual risk-factor identification model which may serve as a guide to practitioners in relapse prevention. [ABSTRACT FROM AUTHOR]

Aims. This study presents development, empirical testing and validation of an instrument measuring service user involvement in in-patient mental health from the mental health professionals’ perspective. Background. Service user involvement is high on the agenda in European mental health policies. In Norway, focus is on enhanced service user involvement at both the individual and organisational levels of in-patient mental health services. Mental health professionals are in an important position to ensure opportunities for real user involvement in in-patient mental health care. However, there is a need for more empirical knowledge on how mental health professionals attend to service user involvement. Design. Survey. Methods. A self-report questionnaire was designed and administered to 121 mental health professionals, with 98 responses, working in a community-based mental health centre in western Norway. Factor analysis procedures together with reliability testing were performed. Results. A 30-items instrument was developed. The instrument contains four components/subscales: (1) Democratic patient involvement (mean score 3·74, Cronbach’s alpha 0·81), (2) Carer involvement (mean score 3·67, Cronbach’s alpha 0·82), (3) Assisted patient involvement (mean score 4·05, Cronbach’s alpha 0·78) and (4) Management support (mean score 4·10, Cronbach’s alpha 0·75). These subscales were found to be essential to service user involvement in the context of in-patient mental health care. The total mean score for the instrument was 3·88, Cronbach’s alpha 0·88. Conclusion. Empirical testing of the instrument demonstrates that the measurement of mental health professionals’ perception of service user involvement has a reasonable level of construct validity and reliability. Relevance to clinical practice. We have developed a measurement instrument with items reflecting essential characteristics to user involvement in in-patient mental health services. We believe that answering this questionnaire on the subject user involvement can act as one step towards enhancing awareness of this issue and to assess user-oriented practices in treatment and services. [ABSTRACT FROM AUTHOR]

Research demonstrates that mental illness is not a major cause of violence yet assumptions about a link and concern about the risks posed by mentally disordered people has resulted in the predominance of a public safety role for mental health services (Munro and Rumgay 2000). In consequence, screening, classifying and monitoring individuals considered to pose a potential risk to others due to their potential for violence has become a key responsibility. The purpose of healthcare screening is to identify a disease or condition, or its associated risk factors, to provide treatment or encourage preventative action on the part of 'at risk' individuals. Mental health screening differs since neither a disease entity nor a causal model to link mental disorder and violence exist (Leitner et al. 2006). Mental health service users are typically marginalised and screening may occur without their consent, knowledge or involvement. They may also disagree that they have the condition in question, i.e. a propensity to violence. The expectation upon professionals to promote service user involvement in care and treatment sits uneasily with these processes. This paper reviews the ongoing but unsuccessful efforts to develop effective screening for violence amongst people defined as mentally disordered and explores the implications for mental health services in the light of this evidence. It also considers the continuing lack of service user involvement in risk assessment. First however, the paper considers correlates for violence since screening depends for its efficacy upon risk factors thought to be positively associated with the condition of concern. [ABSTRACT FROM AUTHOR]

Service user involvement has been spoken and written about for many years in a variety of settings, and is generally considered a good thing. A number of elements of service user involvement have been much debated, including the extent to which service users can realistically be involved in shaping services, who counts as a service user, and how service users can be included when the processes involved in commissioning can be complex and technical. This article considers some of the key issues concerning user involvement in strategic and other commissioning arising from research commissioned by the Joseph Rowntree Foundation. The findings prompt those who are engaged with service user involvement to consider how culture may be as important as, if not more important than, structure when engaging with service users in service design and delivery. [ABSTRACT FROM AUTHOR]

Summary: This paper reports on a participatory action research project focusing upon service-user involvement in the assessment of student mental health nurses in practice. The principle of student nurses being assessed by service-users was found to be desirable in theory. However, its implementation proved to be fraught with difficulty especially with regard to the concerns about increased workload and feelings of vulnerability amongst students. It is recommended that the model of assessment should be adjusted to that of review and that a program of service-users reviewing student nurses on placement be implemented and evaluated. [Copyright &y& Elsevier]

The purpose of this paper is to review some of the key mental health education and training developments of the last decade of immense change to the service system in England. This change was part and parcel of the Labour Government's mental health modernisation agenda. [ABSTRACT FROM AUTHOR]

Good communication between service providers and service users has been widely recommended in the rehabilitation of acquired brain injury and other long-term neurological conditions. This paper summarises the process of developing and evaluating a set of three patient information leaflets as one aspect of such communication within an adult inpatient neurorehabilitation setting. Service user feedback was elicited via a questionnaire given to all consecutive admissions (patient or family member as appropriate) over a six-month period. Overall, participants reported the leaflets to be useful, easy to read and leading to perceived increases in understanding. The stages involved in developing appropriate materials suitable for a mixed audience of both patients and carers are outlined. Key issues identified during this project are also discussed, including the need for clarity regarding the aims of the information prior to development (eg information versus promoting compliance) and the need to consider readability levels, while also recognising the necessary use of some rehabilitation-specific vocabulary. This paper and subsequent reflection will have relevance for future informationprovis ion projects within the authors' centre, and for many other services embarking on similar endeavours. [ABSTRACT FROM AUTHOR]

‘Service user’ advisory representation is required by law and/or regulation in British social, health and educational programmes. This is similar to client counsels or consumer groups in the USA, which are required in some, but not all, US social service sectors. Often users of welfare services are excluded from citizenship – both formally and in terms of actual restraints on their citizenship rights. There remains uncertainty, however, about how best to identify and enable such individuals to participate in service user involvement without continued marginalisation. This study seeks to contribute to our emerging understanding of service user initiatives by exploring preferred terms of reference and service user involvement from the point of view of persons often categorised as service users by social policy, health and social care providers and academics, but who do not necessarily take part in self-organised service user groups. [ABSTRACT FROM AUTHOR]

Aims: This article describes the development, content and evaluation to date of an in-service, interdisciplinary training programme on psychological and communication problems after stroke. The training is open to all staff but is particularly focused towards qualified and unqualified nursing staff and therapy assistants who work in acute stroke care and rehabilitation both in hospital and community settings. Content: The programme, developed by the authors whose backgrounds include speech and language therapy, occupational therapy, and clinical psychology, aims for all staff to develop an integrated, patient-centred approach to care, and addresses issues such as improving the patient and carer experience of rehabilitation, as well as reducing the negative psychosocial consequences of stroke. Service users are involved in delivering the training. Informal evaluation highlighted improvements for trained staff in knowledge and perceived confidence in the recognition and basic management of communication, cognitive and emotional problems after stroke. Conclusions: Limitations in evaluation in terms of design, methodology and data are acknowledged, however, preliminary findings highlight the benefits of this programme in holistic stroke care delivery. Suggestions are made regarding future more empirically rigorous research into longer-term effects of the training both for staff and patient outcomes. [ABSTRACT FROM AUTHOR]

This paper discusses the impact on mental health service users of the computerised healthcare programme currently being developed by the NHS that aims to make healthcare information available on a much wider basis than is currently the case. The potential benefits of electronic health records are considerable in terms of enhancing effective and safe healthcare. Yet electronic databases, whatever their purported aim, open up the potential for greater surveillance in a state where dissidence is becoming less easily tolerated and technological advances allow greater inroads into private lives. With a specific focus upon service users considered to pose a risk to other people, and drawing upon qualitative research jointly conducted by the author, this paper focuses upon the use of risk assessments in practice, the accuracy of information about risk, service users' rights re access to information, their involvement in risk assessment and the objectivity of risk information. The paper concludes with a discussion of possible outcomes for mental health service users and professionals. [ABSTRACT FROM AUTHOR]

Background: Little research or policy guidance about the involvement of mental health service users in risk assessment exists. Aims: To explore how mental health professionals assessed risk to others and the extent to which they involved service users. To ascertain service users' knowledge of, and involvement in, risk assessment. Method: Qualitative research methodology was used and semi-structured interviews were conducted with mental health services users and professionals. Results: Four key themes arose (i) some professionals lacked confidence or experience in discussing risk openly with service users, (ii) most were not involving service users in risk assessments, (iii) the majority of service users were unaware that professionals were undertaking risk assessments on them, and (iv) there were differing levels of agreement between professionals and service users about risk and its seriousness. Conclusion: There is a research and practice gap about effective means of engaging service users in risk assessment. Declaration of interest: The original study upon which this paper is based was funded by the Joseph Rowntree Foundation. [ABSTRACT FROM AUTHOR]

An emphasis on the outcomes of health and social care services has become increasingly apparent within public policy in the United Kingdom. Alongside this, working in partnership has been a key theme, despite a relatively underdeveloped evidence base. Of central importance, however, must be whether directives toward partnership working are delivering improved outcomes, and in particular, the outcomes that are valued by service users. The authors describe a project that sought to identify the outcomes important to people with intellectual disabilities, and where possible, whether partnerships delivered these outcomes. The research was primarily based on interviews with service users and carers, and involved people with intellectual disabilities as both researchers and research subjects. The project categorized key outcomes in two categories (quality of life and process) and identified ways in which health and social care partnerships can deliver the outcomes service users want. If agencies are to deliver good outcomes to users, as increasingly emphasized in policy, this focus should accurately reflect the outcomes that users themselves define as important. [ABSTRACT FROM AUTHOR]

In the last five years there has been an increased drive to include the perspectives and contributions of service users in social work education in the United Kingdom. In this paper we discuss the experience of one project that attempted to bring together service users, academics and practitioners to jointly develop and deliver a module that sought to examine the perspectives of families living in poverty who were in receipt of children and families social work services. Through doing this it was hoped that it would be possible to raise practitioners' awareness of how poverty impacts on parenting and how they could develop an approach that was non-punitive and genuinely supportive. The paper starts by exploring the context of service user involvement in social work education and then describes the development and process of this collaborative project. The paper concludes with recommendations for both projects seeking to engage service users in empowering and meaningful ways, as well as social work practice within an anti-oppressive framework. [ABSTRACT FROM AUTHOR]

In the UK context, the Research Assessment Exercise (RAE) has been developed as a means of evaluating research performance. This reflects a growing international interest in such evaluation. This article explores emerging tensions between such external review processes and increasing interest in, and efforts to conduct, participatory and emancipatory research in fields such as nursing and social work. We argue that the pressure from such demands, and the resulting outcomes, risk undermining such research and efforts to develop more equal research relationships that can address power imbalances with people who use services. The article examines prevalent academic demands arising from responses to successive RAEs and briefly explores the rationale for participatory and emancipatory research approaches. [ABSTRACT FROM AUTHOR]

The Greater Manchester Multiple Sclerosis Management Audit was carried out in 2006 by Taylor and Walton to compare the management of multiple sclerosis (MS) in Greater Manchester against national recommendations for the management of MS set down by NICE (National Collaborating Centre for Chronic Conditions, 2004). This audit revealed that MS services in Greater Manchester were only partially compliant with the standards defined in this audit, which were derived from the NICE guidelines. Discussion within the MS Clinical Governance Group resulted in a proposal for a website to supply information about local services. This article discusses the development of the website with reference to the relevant audit results and the standards defined in the audit for information giving. It was identified at an early stage that service user involvement would be essential to the success of the website project. A period of consultation by MS Society branches was led by volunteers, followed by an email consultation of the health and social care professionals via the MS Special Interest Group. The website content was then agreed and compiled and the website went live in December 2007. The website gives details of local MS services as well as information about events and courses for people affected by MS, details of research trials and links to other relevant websites. A summary of service user and service provider feedback is included alongside quantitative data relating to the use of the website since going live. [ABSTRACT FROM AUTHOR]

This paper reports on the findings of a small-scale research project investigating the views of social work students on the use of decision analysis. After giving the context of the research, the article reports on what was found when students, who had just completed a Decision Making and Risk module, were asked for their opinions on the component parts of decision analysis, its use as a practice tool and their attitudes to using it on placement. The research found that the respondents in general took a critical and supportive stance towards the use of decision analysis in social work and, with extra teaching and a positive approach from their practice assessor, would be happy to use decision analysis. When the same group of students completed a follow-up questionnaire on a placement recall day, half of them had thought about using decision analysis but only three had gone on to discuss this with their practice assessors. Some issues in relation to connecting 'classroom' and 'field' are identified and the paper concludes that a number of further steps would be necessary to realise the potential of decision analysis to help students be more systematic and analytical in their approach to decision making. [ABSTRACT FROM AUTHOR]

Requirements set out for the social work degree and post-qualifying framework specify the involvement of service users and carers on a number of levels. Research indicates that service user and carer involvement can benefit students, professionals and service users and carers themselves. To keep up with demands placed on service users and carers by higher education institutions and other social work bodies, the issue of capacity needs to be addressed. This paper describes a programme (Getting Involved) designed by Skills for Care to build capacity to participate among service users and carers new to social work education. It describes the experience of piloting the programme in Dorset by a team at Bournemouth University consisting of service users and carers and staff from the Centre for Post-Qualifying Social Work. Getting Involved is a welcome development and the outcomes of the pilot have been extremely positive for all involved. The process of undertaking and evaluating the pilot raised issues concerning setting up programmes, project management, service users and carers as co-researchers and sustainability. These are discussed in terms of our experience and how they link with the literature. Lessons learnt and implications for similar work in the future are highlighted. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: In the UK policy recommends that service users (patients, carers and the public) should be involved in all publicly funded health and social care research. However, little is known about which approaches work best in different research contexts and why. The purpose of this paper is to explain some of the theoretical limitations to current understandings of service user involvement and to provide some suggestions for theory and methods development. This paper draws upon findings from a review of the research ‘evidence’ and current practice on service user involvement in the design and undertaking of nursing, midwifery and health visiting research. Design: A multi-method review was commissioned by the NHS Service Delivery and Organisation (SDO) Research and Development Programme. The timeframe was April 2004–March 2005. The full report (Ref: SDO/69/2003) and supplementary bibliography are available from: http://www.sdo.lshtm.ac.uk. Review methods/data: Initial searches of the health and social care literature and consultations with researchers were used to develop a broad definition of the topic area. A service user reference group (26 members) worked with the project team to refine the scope of the review, to set inclusion criteria and develop a framework for the analysis. Systematic searches of the literature were undertaken online and through library stacks (345 relevant documents were identified). Ongoing and recently completed studies that had involved service users were identified through online databases (34 studies) and through a national consultation exercise (17 studies). Selected studies were followed up using telephone interviews (n=11). Members of the service user reference group worked with the research team to advise on key messages for dissemination to different audiences. Results: Information was gained about contextual factors, drivers, concepts, approaches and outcomes of service user involvement in nursing, midwifery and health visiting research, as well as developments in other research fields. Synthesis of this information shows that there are different purposes and domains for user involvement, either as part of researcher-led or user-led research, or as part of a partnership approach. A number of issues were identified as being important for future research. These include: linking different reasons for service user involvement with different outcomes; understanding the relationship between research data and service user involvement, and developing conceptualisations of user involvement that are capable of accommodating complex research relationships. Suggestions for the development of practice include: consideration of diversity, communication, ethical issues, working relationships, finances, education and training. Conclusions: Because research is undertaken for different reasons and in different contexts, it is not possible to say that involving service users will, or should, always be undertaken in the same way to achieve the same benefits. At a research project level uniqueness of purpose is a defining characteristic and strength of service user involvement. [Copyright &y& Elsevier]

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This paper presents the findings of the third stage of a research study, the overall aim of which was to evaluate the educational preparation for cancer and palliative care nursing for children and adolescents in England. The specific aim of this stage was to define the attributes of `threshold' and `higher level' practice in nursing in order to inform the outcomes of future educational programmes.The research design involved children, their parents and their nurses at two different stages in the study. The first stage was the construction of the research instruments, in this case video and audio recordings of episodes of care in which the children participated. The second stage was the review of the recordings by the children, their parents and other stakeholders involved in their care. Service users were also involved in the management of the project.The study findings suggested that although there was considerable agreement between service users and other stakeholders about the characteristics of adequate or threshold practice, for both cancer and palliative care, there was less agreement about what constituted higher level or expert practice — other than `more of the same but better'. The key areas of importance for future professional development courses were agreed as partnership working, clinical skills, multidisciplinary working and the personal attributes of the nurse. [ABSTRACT FROM PUBLISHER]

Background: Self-help approaches for mental health problems are a research and service development priority within the UK. Aim: To engage service users in the research process through a consultation exercise, seek their views on the strategies they use to manage their lives and priorities for research into self-help. Method: Service users were involved in planning and conducting a consultation event and in analysing, interpreting and disseminating the findings. Forty nine service users attended the consultation event. Notes and key points from focus groups discussions were analysed to identify main themes. Results: Five themes for service user self-help strategies were identified; managing and structuring the day; empowerment; engaging others to help yourself; physical health and well being; and spirituality. Four research priority areas in self-help were identified: the importance of user-led research; research into self-help strategies to improve physical health and well being; mapping of available services and self-help approaches; and what works and why. Conclusions: Self-help research and developments should take account of these service users' views of research priorities and the strategies they use to manage their lives. Declaration of interest: The project was initiated by Psychological Therapies Network North (PsyReNN). Funding for the venue and service user expenses was provided by the NIMHE Regional Development Centre, North East, Yorkshire and Humberside and by the Tees and North East Yorkshire Mental Health and Learning Disabilities NHS Trust. [ABSTRACT FROM AUTHOR]

This paper explores a citizen-based approach to social work which may counter modern negative managerialist pressures on practice. It links the discourse concerning the growth of user involvement in public policy with the discourse about participation in political activity and suggests a role for social workers in supporting service users in initiatives such as self-help, campaigning and community action which offer a new interpretation of community-based social work. By engaging in this activity, health and social care professionals can support people to participate in emerging forms of active and inclusive citizenship. While participation in traditional political activity such as voting and political party membership is declining in the UK, people in marginalized groups are finding ways to have their voices heard about issues which directly concern them. increasingly, groups such as disabled people, older people and mental health service users/survivors are taking part in activity which marks a shift of focus to include both self-help and campaigning. In contrast to their disillusion with traditional political activity, people across a range of groups have gained strength and encouragement from campaigning achievements. The paper draws on a national research study which offers fresh insights on these issues as a basis for exploring participative approaches to social work practice. [ABSTRACT FROM AUTHOR]

In order to support children and young people who are exploring their gender, we need to develop a shared understanding of gender identities and enhance the evidence base relating to long-term outcomes. All professionals working with children and young people should be trained in gender diversity. Health-care systems must be adapted to enable us to record gender identity; outcome measures should be developed that accommodate different gender identities. In doing so, we will develop clearer information about the number of children and young people who are exploring their gender and the way that gender identities develop throughout childhood. We will also start to demystify gender and work to enhance understanding and acceptance of diversity. [ABSTRACT FROM AUTHOR]