A novel method for obtaining service users’ perspectives on community mental health services in order to influence design of systems.

Introduction

Despite the recommendation and likely benefits, service user involvement in decision making about how services are delivered remains limited. Often individual service users are asked to advise rather than obtaining experiences systematically from diverse groups.

 When support is provided across multiple community organisations (voluntary, social and health sectors), a number of challenges hinder routine acquisition of service user experiences. These include building trust, as well as obtaining formal permissions in an increasingly bureaucratic world.

This presentation describes how we have created a system to obtain the perspectives of a diverse range of services users about their experiences of services aiming to reduce health inequalities.



 Methods

Initially two researchers were embedded into a system in order to understand initial access and flow between teams. We worked with service user groups and practitioners to understand both a focus for the evaluation and ideas about how to obtain data about experience of care. We worked with ethics and governance experts to design a legal, flexible and person centred approach to obtaining relevant data. We will use realist analysis to understand mechanisms influencing patient journeys.



Results

Service users advocated for depth understanding of patient journeys through case studies and for a simplified single page Information sheet.  We will approach those early in the path as well as those engaged in therapy. We will recruit more vulnerable individuals by building trust during observation of care and inviting them to ‘go-along’ interviews. We have started interviewing and observing care, creating detailed case studies by “following” 20-30 service users over 3–8-month period to create rich narratives of journeys.

 

Conclusions

We will report on our initial findings showing  how accessibility and flow are influenced by team culture, facilitators and gatekeepers and voice of service users.  And report on how findings are influencing service design.