Katsikitis M, Lane B R, Ozols I, Statham D
School of Social Sciences, University of the Sunshine Coast, Maroochydore DC, QLD, Australia.
Mental Health at Work, Melbourne, VIC, Australia.
J Psychiatr Ment Health Nurs. 2017 Sep;24(7):534-544. doi: 10.1111/jpm.12394. Epub 2017 Jun 29.
WHAT IS KNOWN ON THE SUBJECT?: Around the world, recovery has become a focus in mental health policy. The participation of people accessing mental health services (consumers) and carers of such individuals in decision-making related to services forms part of this recovery orientation and studies suggest positive outcomes following such participation. However, little is known about consumer and carer desires at the earliest stages of development of new services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Consumers and carers desire changes to how mental health services are provided. Many factors affect consumer and carer experiences, including language use, physical design of spaces, accessibility, consideration of individual needs, practical help and how well care is continued from hospital to community settings. Carers may feel sidelined in treatment and be distressed as a result. They wish to be respected and involved in recovery. Consumers and carers wish for focus on broader health, with care taken to address physical health, psychological needs, social needs and treatment of the whole person rather than just an illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Consumers and carers desire partnership with professionals in recovery. Tokenistic participation should be avoided. Flexibility in how services are provided and less formality may help engage consumers and carers. Specifically, professionals may help by linking consumers and carers to services that address practical needs. Professionals should communicate with carers to draw on their expertise about the individual accessing the mental health service and help carers understand how they can assist the individual's recovery.
Introduction Recovery-oriented mental health policies recognize consumer and carer participation in service decision-making as essential, but little is known about the views of these individuals in the earliest stages of service development. Aim This study sought consumer and carer perspectives addressing the establishment of a mental health research, treatment and teaching facility in their region. Methods Two 2-hr focus groups were conducted, with separate groups held for mental health consumers (n = 9) and carers (n = 9), respectively. Discussions pertained to mental health literacy, gaps in current services, desires for an ideal facility (in terms of physical design and services offered) and what would help in recovery. Results Inductive thematic analysis was used to generate three themes: care outside of consultations, carer involvement in recovery and holistic approaches to mental health care. Consumers desired a facility that could cater to individual needs. Carers felt excluded in recovery and unable to provide effective support. Both groups preferred holistic approaches to mental health, expressing ambivalence towards medication and hospitalization. Discussion Consumers and carers have many needs that conventional practices may not meet. Implications for practice They have clear desires for equal partnership in recovery and for transformation of conventional treatment methods.
关于该主题已知的信息有哪些？在全球范围内，康复已成为心理健康政策的重点。使用心理健康服务的人群（消费者）及其护理人员参与与服务相关的决策，是这种康复导向的一部分，研究表明这种参与能带来积极成果。然而，对于新服务开发的最初阶段消费者和护理人员的期望却知之甚少。本文对现有知识的补充有哪些？消费者和护理人员希望心理健康服务的提供方式有所改变。许多因素会影响消费者和护理人员的体验，包括语言使用、空间的物理设计、可达性、对个体需求的考虑、实际帮助以及从医院到社区环境中护理的延续情况。护理人员可能会觉得在治疗中被边缘化并因此感到苦恼。他们希望得到尊重并参与到康复过程中。消费者和护理人员希望关注更广泛的健康，要注意解决身体健康、心理需求、社会需求以及对整个人的治疗，而不仅仅是疾病。对实践有哪些启示？消费者和护理人员希望在康复过程中与专业人员建立伙伴关系。应避免象征性的参与。服务提供方式的灵活性和减少形式化可能有助于吸引消费者和护理人员。具体而言，专业人员可以通过将消费者和护理人员与满足实际需求的服务联系起来提供帮助。专业人员应与护理人员沟通，利用他们对使用心理健康服务个体的专业知识，并帮助护理人员了解如何协助个体康复。
引言 以康复为导向的心理健康政策认为消费者和护理人员参与服务决策至关重要，但对于这些个体在服务开发最早阶段的观点却知之甚少。目的 本研究旨在了解消费者和护理人员对在其所在地区建立一个心理健康研究、治疗和教学设施的看法。方法 分别针对心理健康消费者（n = 9）和护理人员（n = 9）进行了两个时长为2小时的焦点小组讨论。讨论内容涉及心理健康素养、当前服务的差距、对理想设施的期望（在物理设计和提供的服务方面）以及对康复有帮助的因素。结果 使用归纳主题分析法生成了三个主题：咨询之外的护理、护理人员参与康复以及心理健康护理的整体方法。消费者希望有一个能满足个体需求的设施。护理人员觉得在康复中被排除在外且无法提供有效支持。两组都倾向于心理健康护理的整体方法，对药物治疗和住院治疗表现出矛盾态度。讨论 消费者和护理人员有许多传统做法可能无法满足的需求。对实践的启示 他们明确希望在康复中建立平等的伙伴关系，并改变传统治疗方法。
