a Research School of Psychology, The Australian National University , Canberra , ACT , Australia .
b School of Social Sciences and Psychology, Western Sydney University , Penrith , NSW , Australia , and.
J Ment Health. 2016 Jun;25(3):231-7. doi: 10.3109/09638237.2015.1124383. Epub 2015 Dec 24.
Consumer and carer participation in mental health service development and evaluation has widespread nominal support. However, genuine and consistent participation remains elusive due to systemic barriers.
This paper explores barriers to reform for mental health services from the perspectives of consumers and carers actively engaged in advocating for improvements in the mental health system.
Qualitative research with two mental health systemic advocacy organisations analysed 17 strategic communication documents and nine interviews to examine barriers to reform and participation identified by consumer and carer advocates and staff.
A number of individual-level barriers were described, however advocates gave more focus to systemic barriers, for which five themes emerged. These reflected lack of awareness, limited participation opportunities, slow progress for change, policy issues and mental health culture including stigma.
Findings highlight systemic barriers to participation for consumer and carer advocates as a whole and the influence of these barriers on the individual experiences of those engaged in advocacy and representation work. Participants also emphasised the need for leadership to overcome some of these obstacles and move towards genuine consumer and carer participation and reform. Findings are discussed in the context of power within mental health systems.
消费者和照顾者参与心理健康服务的发展和评估得到了广泛的认可。然而,由于系统障碍,真正和持续的参与仍然难以实现。
本文从积极倡导改善心理健康系统的消费者和照顾者的角度出发,探讨精神卫生服务改革的障碍。
对两家精神卫生系统倡导组织进行了定性研究,分析了 17 份战略传播文件和 9 份访谈,以调查消费者和照顾者倡导者和工作人员所确定的改革和参与障碍。
描述了一些个人层面的障碍,但倡导者更关注系统性障碍,为此提出了五个主题。这些主题反映了缺乏意识、参与机会有限、变革进展缓慢、政策问题以及包括耻辱感在内的心理健康文化。
研究结果突出了消费者和照顾者倡导者面临的系统性参与障碍,以及这些障碍对参与倡导和代表性工作的个人经历的影响。参与者还强调了领导层克服这些障碍的必要性,以实现真正的消费者和照顾者参与和改革。研究结果在心理健康系统内的权力背景下进行了讨论。