Northwestern Mental Health, Monash University, Melbourne, Victoria, Australia.
Int J Ment Health Nurs. 2011 Jun;20(3):155-64. doi: 10.1111/j.1447-0349.2010.00719.x. Epub 2011 Feb 18.
Consumer participation occurs in all Victorian public mental health services. Area mental health services employ consumer consultants to enhance consumer participation across the network. Ongoing support of management is essential to the success of consumer participation. This project aimed to explore understandings of consumer participation from a manager's perspective. Semistructured interviews were conducted with seven participants in this qualitative, interpretive study. The thematic analysis revealed the complexities around defining consumer participation and demonstrated the difficulties and possible reasons as to why there is no real clarity between managers, service providers, and consumers as to what consumer participation should look like. Power and change were the primary themes. Power and the overwhelming consensus that the medical model and those working within it hold the most power was strongly represented in this study. Legislation and workplace settings were seen as considerable factors adding to the disempowerment of consumers within an already disempowering mental health system. Change was the other main theme that emerged, with culture and attitudes of the old 'institutionalized' thinking that still pervades some pockets of mental health services being seen as the major barriers to change. The role of the consumer consultant was a prominent subtheme, with their role in training and the education of workers seen as an essential and positive way to progress consumer participation. These findings demonstrate that managers consider there to be hope for consumers, brought about by collective action and lobbying, and through consumer participation in less-restrictive parts of the service (community settings).
消费者参与存在于所有维多利亚州的公共精神卫生服务中。地区精神卫生服务机构聘请消费者顾问，以增强整个网络中的消费者参与度。管理层的持续支持对于消费者参与的成功至关重要。本项目旨在从管理者的角度探讨对消费者参与的理解。在这项定性、解释性研究中，对 7 名参与者进行了半结构化访谈。主题分析揭示了定义消费者参与的复杂性，并表明了为什么在管理者、服务提供者和消费者之间对于消费者参与应该是什么样子没有真正的共识，存在困难和可能的原因。权力和变革是主要主题。权力以及压倒性的共识，即医疗模式及其内部人员拥有最大的权力，在这项研究中得到了强烈体现。立法和工作场所环境被视为使消费者在已经剥夺权力的精神卫生系统中进一步失去权力的重要因素。变革是另一个主要主题，文化和态度仍然存在，旧的“制度化”思维仍然存在于一些精神卫生服务领域，被视为变革的主要障碍。消费者顾问的角色是一个突出的子主题，他们在培训和教育工作者方面的作用被视为推进消费者参与的必要和积极方式。这些发现表明，管理者认为消费者有希望，这是通过集体行动和游说带来的，并且通过消费者参与服务中限制较少的部分（社区环境）来实现。
