ESC Module 3

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Page

TheTenEssentialSharedCapabilities

Module3:

Involvingserviceusersandcarers

Welcome to this module that explores the link between the Ten Essential Shared Capabilities

and service user and carer involvement.

After completing this module you will be able to:

Describe the link between service user involvement, carer involvement and the

Ten Essential Shared Capabilities.

Answer the question: what is service user and carer involvement?

Present evidence about how you are promoting service user and carer

involvement.

Contents

.Startingpoints .................................................................................................. 2

2.Serviceuserandcarerinvolvement ................................................................. 5

3.Recovery............................................................................................................ 15

4.Overcomingbarrierstoserviceuserandcarerinvolvement........................... 26

5.Evaluation.......................................................................................................... 32

6.Linkstourtherlearning .................................................................................. 34


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Page2Module3:Involvingserviceusersandcarers

How to get the best out of this module:

Complete learning activities as honestly as you can.

Recognise what you do know, and what you dont know Identify small goals that will help to change the way you do things

.Startingpoints

Activity3.

Here are some questions to get you started:

What does service user involvement mean to you?

Do you need convincing about the value of service user involvement?

Mark where you are on this scale:

No YesUnsure

Where is service user involvement in your list of priorities?

Mark where you are on this scale:

Low HighMedium

Give some reasons for this:

What would help you to move further up this scale?



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Where do you place carer involvement in your list of priorities?

Mark where you think you are on this scale:

Low HighMedium

What would help you to move further up this scale?

Is your attitude to service user and carer involvement the same or different - why do you

think this is?

How can involving carers help service users to recover?

Read the denitions below which show the challenges of nding the right language to talk

about mental distress.

Mentalillness,mentalhealthproblemsormentaldistress?

romtheStrategiesorLivingreport(FaulknerandLayzell2000):

Wehaverequentlyusedthetermmentaldistresswhereotherpeoplemay

preersuchtermsasmentalillnessormentalhealthproblemswerecognise

thatnotallexperiencesorbehavioursassociatedwithadiagnosisomentalillness

arenecessarilyexperiencedasdistressing.Wedobelievethereisacontinuumo

distressandthateveryoneisonthatcontinuum.

Manypeoplendtheconceptomentalillnessauseulwayothinkingabout

theirexperiences.

Othersbelievethatusingthetermmentalillnessencouragesproessionalsto

labelpeoplewithinarestrictedsetocategoriesandtreatthemaccordingly.



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Patient,Client,User,ServiceUser,Survivor,allthesetermsandmanyotherso

amorenegativenatureareusedtodescribepeoplewithmentaldistresswhohave

orareusingmentalhealthservices.Workersneedtobesensitivetotheimplications

otheirlanguage.Serviceuseristhemostcommonlyacceptedtermatthistimealthoughitisnotalwaysliked.Userorsomepeoplemeansdruguserandisseen

asinsulting.Survivormaysuggestpersonalpowerandchallenge,whichisvery

demanding(andperhapseventhreatening)toserviceusersandtomentalheath

workers.Patientplacesmentalhealthcarermlywithinthemedicalworld/model.

Manylearningprogrammesnowpresentabio-psycho-socialmodel,whichoersa

holisticviewocare,recognisingthatapersonssocialworldisasimportantastheir

psychologicalandphysicalworld.Whileeachothetermsusedhasitsvaluethe

constantcryotheserviceuseristobeacknowledgedasauniqueandindividual

humanbeing.

Carer,Signicantother,Lovedone,Relative,Friend,Child,Describingsomeoneasa

carermaybeproblematic.Thewordcarermayimplybeingpaid.Manypeoplewho

providesupportdonotrecognisethistermandpreertoseethemselvesinterms

otheirrelationship-orexampleasapartner,mother,brotherorriend.Acarer

hasbeendescribedassomeonewhoprovidesorintendstoprovidepracticaland

emotionalsupporttosomeonewithamentalhealthproblem.Theymayormay

notlivewiththepersontheycareor.A Commitment to Carers Leaet Rethink/

Department of Health

To demonstrate capability in relation to the ESC you need to:

understand what is meant by service user and carer involvement

actively promote service user and carer involvement yourself

develop skills to involve service users and carers effectively

use strategies to overcome barriers to involvement

The need to involve service users and carers in planning services is a policy requirement.

Good practice also requires mental health workers to Work in Partnership (ESC 1) with

service users and carers.

Allmentalhealthservicesmustbeplannedandimplementedinpartnership

withlocalcommunities,andinvolveserviceusersandcarers. National Service

Framework for Mental Health - Department of Health 1999

Planningresourcesandcareinpartnershipwithusersomentalhealthservices

isnowrecognisedasbeingthemosteectivewayoensuringservicesmeet

needseectively.Philpot 1994

Truepartnershipshouldalsoresultinusersbeingactiveparticipantsintheir

treatmentandprovidersdoingtheirjobsinamorecollaborativeandmutuallysupportiveway.Trivedi 1996



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2.Serviceuserandcarerinvolvement

Service user and carer involvement can happen at different levels and in different ways.

Evidence that real involvement exists might include:

Service users and carers being actively and effectively involved as equal partners in care

planning and the Care Programme Approach (CPA). CPA is a framework for assessment,

care planning and review in mental health servces.

Try to think of some more examples of how service users can be involved and record them

below:

Where real involvement exists service users should be able to:

Give formal and informal feedback to individual workers

Have access to user-friendly advocacy and complaints services

Design and carry out surveys and audits on services

Join self help, service user or campaigning organisations

Be members of management, clinical governance and PPI (Patient and Public

Involvement) groups

Take part in planning, delivering and evaluating learning

Get jobs in mental health services

Interview and help to appoint staff

Run services themselves

Rethink (2003) recommends that carers should:

Be recognised and listened to as a partner in providing care

Be valued

Be treated with courtesy and respect

Be able to talk to a mental health or social care professional on request

Receive information as early as possibleReceive prompt and positive responses to requests for help

Be able to get immediate help in a crisis

Have their own needs assessed and met

Be able to have breaks from caring

Be given help in communicating with staff, when needed, for example through

an advocate, interpreter or signer

Be given an explanation of the mental health problem affecting the person they

care for

Be told what treatments the person is receiving, what other treatments are

available, how they work and the potential side-effects

Be given information about what support will be provided when the carer can nolonger care.



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Activity3.2

Looking through the lists above, note some things that you think both service users and

carers are likely to nd helpful:

Your list may include some of these things:

Being listened to and respected

Being given an explanation of the mental health problem

Being told about a choice of treatments and having the opportunity to discuss

this

Being involved in planning the way services are delivered

Being given expenses or payment for consultation activities

Service user and carer involvement exists at the personal, local, regional and national level.

Some examples are:

Memberofacarersgrou

pIn

volvedw

ithRethink

andtheMentalHealthFou

ndat

ion

I

nvo

lvedinCPAofpersonthe

ysuppo

rt

OnCountyCPAgroup

Invo

lvedinownC

PA

Membe

rofloca

lserviceusergroup

Work

ingforN

IMHEregionaldevelopm

entcentre

Attendi

ngMIND

nationalconferences

Service user:

Carer:

Key

Personal:

Local

Regional:

National



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PageModule3:Involvingserviceusersandcarers

Activity3.3

Using the resources available to you (contact list, telephone directory, information from the

Internet or a colleague) identify a local service user or carer group you are not already in

touch with that may be useful to the people you work with. Make a list of things you needto nd out about this group below. Get in touch with them as soon as possible to ask for

information and make a link.

CarePlanning/TheCareProgrammeApproach(CPA)

The Care Programme Approach was introduced to help provide a good standard of

assessment, care planning and review for adults with mental health problems. The way in

which CPA is delivered varies a great deal.

MyCPN(CommunityPsychiatricNurse)isasoundingboard

Iamlistenedtomyviewsandopinionsaretakenintoaccount

Theworkersaidthatwehadameetingyoudontneedtobeseen

Iwasinastatewhenithappeneddidntknowwhatwasgoingon

IwastoldtheCPNiscarryingitout

DierentexperiencesoCPAromaserviceuserconsultationevent-

CAPITALWestSussex-2005

ThisreportoundthatthemajorityoserviceusersdonotknowwhatCPA

isor.Governmentpolicyisthatusersshouldbeinvolvedindrawinguptheir

careplan.ButoallthesitesvisitedbyUFM(UserFocussedMonitoring)

interviewers,onlyserviceusersinHuntingdonevenknewwhotheirCPAkeyworkerswereorthattheyhadacareplan.Evenewerserviceusersknewthe

dateotheirnextCPAreview.Rose200



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It is essential to involve service users in the Care Programme Approach. Here are some

important points to keep in mind:

Service users need to be encouraged and allowed to express an opinion. Service

users and carers are entitled to hold an opinion that is different to the workers.Service users need to identify their own strengths, resources and goals.

The workers role is to assist people to reach their full potential.

The service user should be able to give feedback about the care they receive,

without fear.

Service users should receive explanations and information.

The service user should be at the centre of the process, actively involved in any

changes in care.

Service users should receive written copies of care plans, and be offered support

and advocacy to help them to express concerns and unmet needs.

This process should be responsive, exible and part of regular on going

partnership working.

Activity3.4

In your recent experience of care planning are these things happening? (if you are not

involved in care planning think about other activities where service users/carers are or could

be involved in a meaningful way)

Place a mark on the scale below that reects your experience:

No YesUnsure

Which important elements tend to be missing from care planning?

Which of the Ten ESCs are most important when care planning?



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You have probably identied at least six of the capabilities. These are:

Working in partnership. Developing and maintaining constructive working

relationships.

Practising ethically. Recognising the rights and aspirations of service users and theirfamilies.

Promoting recovery. Working in partnership to provide care and treatment that

enables service users and cares to tackle mental health problems with hope and

optimism.

Identifying peoples needs and strengths. Working in partnership to gather

information to agree health and social care needs in the context of the preferred

lifestyle and aspirations of service users, their families, carers and friends.

Providing service user centred care. Negotiating achievable and meaningful goals.

Promoting Safety and Positive Risk Taking which includes Empowering the

person to decide the level of risk they are prepared to take with their health and

safety.

Activity3.5

Now, think about the skills you already have. Concentrate on ESC 7 (providing service user

centred care), as this is central to care planning.

Describe a skill which helps you to provide service user centred care planning:

Describe a skill which you need to develop further:

Set a small achievable goal that will help you to develop this skill:

1.

3.

5.

6.

7.

9.



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Identify someone or something that can help you to achieve this:

Set a timescale for achieving this goal:

It is important to involve carers in care planning too, and to remember that they are often

entitled to assessment and services in their own right.

Carersneedsandstrengths

In supporting carers, services should aim to:

Recognise the valuable role carers have and the stresses that caring can

bring;

Provide timely support for them in this role and help if they can no longer carry

this out all or part of this role;

Ensure participation of carers in planning and developing services so that they

can be more effective and suited to carers needs;

And thus ultimately aim to ensure better outcomes for carers and service users.

The outcomes of a carers assessment should be the production of a focused support

plan outlining who will take responsibility for particular services and what outcomes

will be achieved

The respective views of carers and the person supported are sometimes perceived

by agencies as being divergent or in conict. This may be an accurate perception,

although perceptions can be distorted because mental health professionals may have

more contact with carers at the point of crisis when tensions and emotions are running

high. This may not always be an accurate reection of relationships.

From Developing services for carers and families of people with mental illness

Department of Health - 2002

The role of carers in treatment adherence was not always acknowledged. Carers and

families reported that they were viewed with hostility and suspicion by professionals,

who felt their involvement and interventions were unhelpful. This is likely to be

particularly offensive to carers who provide the majority of care.



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Recommendation 7 - Creating Sensitive Services Carers and advocates must be

identied, invited to care planning meetings as far as is possible in advance, and given

copies of all paperwork unless the service user disagrees... ...Families and carers

should have access to training on mental illness to increase their knowledge and

understanding about symptoms and ways of dealing with it.

From Breaking the Circles of Fear - a review of the relationship between mental health

services and African and Caribbean communities - 2002 - Sainsbury Centre for Mental

Health

Thinkoonepracticalthingyoucandotoinvolvecarersmoreeectivelyandrecord

itbelow:



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Involvementandthewiderpicture

Activity3.6

Now were going to return to thinking about different ways in which service user and carerinvolvement can happen. What is your experience in your current role or setting? Rate the

items below using trafc lights Green = good practice Amber = reasonable practice

Red = poor practice.

Towhatextentareserviceusersableto:G

ood

practice

Reasonablepractice

Poorp

ractice

Offer informal or formal feedback to workers

Access user friendly advocacy and complaints procedures

Design and take part in surveys/audits/research on care issues

Join self help, service user or campaigning groups

Become representatives on management, clinical governance or PPI

(Patient and Public Involvement) groups

Take part in learning events for people from across the mental health

community

Find employment in mental health services

Interview and help to appoint staff

Run services



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Use the same trafc lights to assess how carers experience your service:

Rethink(2003)recommendsthatcarersshould:G

ood

practice

Reasonableprac

tice

Poorpractice

Be recognised and listened to as a partner in providing care

Be valued

Be treated with courtesy and respect

Be able to talk to a mental health or social care professional on requestReceive information as early as possible

Receive prompt and positive responses to requests for help

Be able to get immediate help in a crisis

Have their own needs assessed and met

Be able to have breaks from caring

Be given help in communicating with staff, when needed, for example

through an advocate, interpreter or signer

Be given an explanation of the mental health problem affecting the

person they care for

Be told what treatments the person is receiving, what other treatments

are available, how they work and the potential side-effects

Be given information about what support will be provided when the

carer can no longer care

Taking part in activities can be a daunting experience for service users and carers and you

need to be aware of this. It is important to provide for:

service users and carers working in pairs

realistic timing and length of meetings/learning sessionsproper introductions

availability of written material in advance of meetings/learning sessions, regular

breaks and a clear agenda

feedback, support and development opportunities

It is important that there are several means of service user involvement to suit as wide

a range of people as possible Mental health supported housing manager

Service users can gain a great deal from involvement with service user-led groups:



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Whatitmeanstobepartoaserviceuserorganisation:

(Quotations from a service user consultation event - CAPITAL West Sussex - 2005)



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3.Recovery

In this section of the module there are statements relating to three of the Ten ESC to help

you make a link with service user and carer involvement. There are also some learning

activities to help you to consider the skills that you have in these areas.

Statement 1: The old fashioned view was the doctor knows best, some of them still

think that, but some service users believe they know whats best. It is my life, does

getting help mean Im not in charge any more? Service user

This statement relates to ESC 1 Working in partnership. Developing and maintaining

constructive working relationships with service users, carers, families, colleagues, lay people

and wider community networks. Working positively with any tensions created by conicts of

interest or aspiration that arise between the partners in care.

Activity3.

Give an example of an effective partnership between a worker and a service user or carer

(based on your own experience or that of someone else):

Identify fourspecic things that were being done that made this a partnership:

1.

2.

3.

4.



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Think of a situation you are involved in at the moment where there isnt an effective

partnership between a service user and an individual worker, or an organisation.

What fourspecic steps could you take to make a better partnership?

Set a goal, which might lead to a better partnership:

What is your timescale for achieving this goal?

Statement 2: For too long the mental health system has fostered exclusion, stigma

and inequality Service user

This statement relates to ESC 4 Challenging inequality. Addressing the cause and

consequences of stigma, discrimination, social inequality and exclusion on service users,

carers and mental health services. Creating, developing or maintaining valued social roles

for people in the communities they come from.

1.

2.

3.

4.



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Activity3.

Where do you feel that exclusion, stigma and inequality exist in relation to mental health?

Give three examples from your own work or experience:

Think of an occasion when you saw someone with mental health problems experiencing

negative attitudes or comments or some kind of inequality or exclusion.

Were any other factors involved such as race, culture, ethnicity, disability, gender, age or

sexual orientation?

How did this incident make you feel?

What did you do when this happened?

1.

2.

3.



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Would you do anything differently now youve thought about it?

Statementsaboutrecovery

Recovery is a journey as much as a destination. For some people with mental illness,

recovery is a road they travel on only once or twice, to a destination that is relatively

easy to nd. For others, recovery is a maze with an elusive destination, a maze that

takes a lifetime to navigate.

Recovery does not always mean that people will return to full health or retrieve all their

losses, but it does mean that people can live well in spite of them

Allott 2003

The recovery model of mental health care allows for a wide variety of approaches

to living with and overcoming the problems of mental distress. It does not have as

its goal a cure, nor does it refer to an end product. Rather than thinking in terms of

interventions, medication and services, it asks the mental health worker to consider to

what extent any action works towards or hinders the personal journey and process of

recovery. Adapted from Repper and Perkins - 2003

Trying to get the right information for me and my family about my health and

resources has been like being on the slow train to London without any stops. Half the

time the mental health services didnt want to tell me what I wanted to know and half

the time I was too scared to ask. Service user

These statements relate to ESC 5 Promoting recovery. Working in partnership to provide care

and treatment that enables service users and carers to tackle mental health problems with

hope and optimism and to work towards a valued life style within and beyond the limits of any

mental health problem.

To move towards recovery a person has to nd new ways of living either by seeing the world

differently or accessing different resources. Having information about a range of choices is

essential.

Workers have information about the service user, their own organisation and other

community resources. The service user or their carer may not have any of this information.

Activity3.



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FrankisaBlackArican-CaribbeanBritishmaninhismid-thirties.Hekeepsinclose

contactwithhisolderbrotherPaulwhohasusedmentalhealthservicesormany

years.HesupportsPaulasmuchasheisableinhisday-to-daylieandalways

visitshimwhenheisinhospital.Franksaysthathisbrothergetsverydownromtimetotimeandbecomesunnyinhishead.Pauleelshistroublesarespiritual

innatureandalthoughhehasbeentoldhehasschizophreniahedoesntagree

withthisdiagnosis.BothPaulandFrankagreethatPaulneedsmorethanjust

medicationandwouldbenetromsomeormoemployment.Bothareverywary

omainstreammentalhealthservices.Frankhasneverspokentoamentalhealth

workeralthoughhecouldbedescribedasPaulsmaincarer.

What do you think Paul needs to know?

What do you think Frank needs to know?

Why did you decide on these things?

How could Paul and Frank access this information? Think of as many ways as you can.

What might stand in the way of them accessing this information?

In this powerful poem from the Open Up Training Pack (Mental Health Media 2004) LloydLindsay communicates how excluded and powerless someone with a mental health problem



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from a Black and Minority Ethnic community can feel:

Lithium to control my condition

To prevent me, the master did prevent me.

To call a ban to where I can go, Cordoning no go areas within my soul

Where mind guards are on patrol

Saying who are you

Who are you, you

And me and them who them are in between me and them who are them

A mental slavery

Internalise lies, lies

Everybody Run

Another broken black man

With ants in his pants

You got ants in you pants mateAnd his tapping feet, tapping a Rasta man chant

Look back at him from the way you are facing

Is it you who look though him or him through you

Or is the feeling mutual



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Identify three things you could do to improve service user and carer access to information

and support generally:

Identify three things you could do to promote access to information where disability, gender,

race, ethnicity or culture is an issue:

1.

2.

3.

1.

2.

3.



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Activity3.0

Now youve seen how hopelessness can spiral downhill design a realistic cycle of hope for a

service user, carer or worker you are involved with at. Start by thinking about an activity that

would offer this person something positive and build up from this.

Acycleohope:



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Once you have completed your cycle of hope, compare it with the example below.

Cycleohopeoraserviceuser:

A CycleOf Hope

Creativeexpression

Growing a senseof self, success and

acceptance

Wanting todo more

Thinking aboutmoney, spending, work

and relationshipsThe worker

believes in changeand is hopeful

Being referred tothe pathways to

work project

Being a volunteerat a theatre

Looking at priorities leisure and work



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Although each cycle of hope is unique as the diagram below shows the same process

applies with each positive action building towards the next.

Communityresources develop an

inclusive capacity

Decreasing Discrimination/Climate of hope enhanced

Hopeful workers who believein people and empowerment

Service users feelencouraged and hopeful

about the future

Recovery seemspossible

Support networks(staff/family/carers)

feel encouraged

Services are moreinclusive and reach

out into their communities

Service users usetheir strengths to work

towards their goals

A CycleOf Hope

Basset, Repper, Tooth, Wilson (2004)



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4.Overcomingbarrierstoserviceuserandcarerinvolvement

Being mentally ill I lost my power. I didnt believe I had any skills of any sort any more

I was useless Service user

For some of us an episode of mental distress will disrupt our lives so that we are

pushed out of the society in which we were fully participating. For others we live with

this sense of hopelessness Repeatedly when we become ill we lose our homes, we

lose our jobs and we lose our sense of identity. We lose sight of our potential. Social

Exclusion Unit - 2004

The Ten Essential Shared Capabilities highlight things you can do to overcome barriers to

service user and carer involvement.

ESC 3 Practising Ethically by acknowledging power differentials and minimising

them whenever possible.

ESC 9 Promoting Safety and Positive Risk Taking by empowering the person to

decide the level of risk they are prepared to take with their health and safety.

Activity3.

Keep these in mind as you read through the case study below:

Alices admission

Alice is a white British woman in her mid-forties. She is admitted to the Accident and

Emergency department (A & E) after taking a small overdose. This is the rst time she

has taken an overdose in 25 years. The staff at A & E are generally helpful. In the early

evening, Alice is interviewed by a mental health nurse. The nurse seems to be intent on

discharging Alice from the start of the interview. The nurse offers no help and she says

on a number of occasions I am empowering you by letting you go home. Alice is not

keen to go home, where she lives alone. After the interview with the nurse one of Alices

friends arrives and in discussion with Alice decides to stay and try to get Alice admittedto the psychiatric unit. Alice is eventually admitted around midnight and remains in the

psychiatric unit for two weeks before being discharged and going home.



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Here are some questions to consider.

What do you think was inuencing the nurse?

How do you think Alice and her carer/friend felt?

What did the nurse do that was unhelpful?

Suggest something helpful the nurse could have said or done:

Power is an important issue in involving service users and carers. Misuse of power by

workers leads to poor outcomes for service users:

Power is the ability to inuence and control people events and processes... It is an

ever present phenomenon Thomson 1998



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Activity3.2

Think of times when you have power, or lack power, in your current role in mental health

services:

I have power when:

I lack power when:

Suggest ways in which you could use your power to empower others:

1.

2.

3.

1.

2.

3.

1.



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Another way of overcoming barriers to promoting service user and carer involvement is

linked to:

ESC 6 - Identifying Peoples Needs and Strengths.

Activity3.3

How strengths-led (rather than problem-led) is the way you work with people?

Mark this scale to show how strengths-led you are:

Notvery Unsure Very

In the last interview/discussion you had with a service user what percentage of the time did

you spend encouraging them to talk about things that they do well and enjoy?

Was this usual or exceptional?

Name one thing you could do differently to draw out service users interests, skills and

positive experiences?

2.

3.



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Identify a specic occasion when you will try this approach:

Now read this account from a service user:

Mymentalhealthworkershavebeenverygood;IstillsaythatmyrstCPN

probablysavedmylie.ButIworryaboutthesystem;Ihaveoundmywaytoa

placeorecoverybytravellinglongdistancesliterallymilestoaskorinormation

aboutmentalhealthandemploymentopportunities.Noonesaidhereiswhereyou

gotondout.Mostoall,myhusbandandchildrenlostoutbecausenoneous

understoodwhatweweredealingwithandnoonesatdownandtalkedwithus

aboutaplantondawayolivingbetter.Therewassomuchheartbreak.

Itsmadeadierencebeingtoldthattheemploymentprojectwasavailable.The

peoplewhoworkwithmeknowIneedfexibilityandextrasupporttostaywell;

Ivaluenotbeingregardedasapersonwithaproblem.Ivemetprejudiceand

judgementromthepsychiatristandellowworkersbutIhavealsoreceivedthe

bestpossiblecareandconcern.Mostimportanttomeisbeingseenassome

onewithvaluewhocanactivelydosomethinguseul.Findingaplacetoreceive

supportoutsidethestatutoryserviceshasbeenbetter.Idontwanttobeontheendobeingdonetoagain.Itmakesmeeellikedirt.Serviceuser



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Activity3.4

Identify specic things you could have done to make sure this service user (and family) felt

involved:

Below are some things that organisations can do to promote involvement:

Information services / advice lines

Advertised opportunities to get involved

Support and Training for involvement

Giving service users inuence and power at Board level

Funding to promote and support involvement

Flexible approaches to getting people involved

Service user and carer involvement champions

Service users and carers working within the organisation to involve others

Now think about your own recent experience of involving service users.

Identify something that you are already strong in:

Identify something that your organisation is already strong in:

Identify something you need to develop further:

Identify something your organisation needs to develop further:



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5.Evaluation

Evaluatingeectivenessoserviceuserandcarerinvolvement

Making sure that service users and carers are involved is a requirement if you work in mental

health services. This includes helping people to make effective links to organisations outside

health and social care services.

Its important to remember that service users have a right to decide how involved they want

to be. They may be anywhere along this scale:

Disengaged Indierent Active

An important part of good practice is making sure that people who have disengaged are

listened to and given a voice.

And its not enough for service user involvement simply to be present, it must be effective.

Service user involvement may be anywhere along this scale:

Absent Present Eective

Effective service user involvement is:

empowering,

moves people towards health and inclusion,

makes a difference to policy and practice.

To judge whether this is the experience of the service users and carers you work with you

can draw on ESC 7 Providing Service User Centred Care, which includes: Systematically

evaluating outcomes and achievements.

The effectiveness of service user and carer involvement can be assessed in a number of

ways:

Asking questions on involvement in CPA assessments / reviews / meetingsService user / carer led satisfaction surveys

Audit

Research studies

Internal inspections / reviews

External inspections / reviews

Organisational development projects

Tick the list to indicate which of these are already being used in your organisation. Now think

of something practical you can do to check that the service users and carers you work with

are involved more effectively.



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I could involve service users more effectively by:

I could involve carers more effectively by:

Now that you have completed the module here are Three key questions to assist you in

further learning:

What are the main qualities required for involving service users and carers in

effective care planning?

How can you overcome conicts that arise when you offer service user and carer

involvement?

What are some practical ways of involving service users and carers in planning

and consultation?

1.

2.

3.



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Websites

Commission for Patient and Public Involvement, see www.cppih.org

Department of Health, see www.dh.gov.uk

Mental Health Foundations website: www.mentalhealth.org.uk. Spend some time looking at

the resources available at this website including the one in four forum.

Mental Health Media, www.mhmedia.com - contact them for the Open Up training pack

(2004)

Mental Health Trainers Network, see www.mhtn.org


Documents

ESC Module 3