In Our Experience: User-focused Monitoring of Mental Health Services in Kensington and Chelsea and Westminster Health Authority ROSE, D., FORD, R., LINDLEY, P., GAWITH, L., and THE KCW MENTAL HEALTH MONITORING USERS' GROUP (1998) The Sainsbury Centre for Mental Health, London: pp. 35. £4.50 or £2 for users. ISBN 1-870480-34-1

✍ Scribed by Steve McKenna

• Publisher: John Wiley and Sons
• Year: 2002
• Tongue: English
• Weight: 27 KB
• Volume: 12
• Category: Article
• ISSN: 1052-9284
• DOI: 10.1002/casp.661

✦ Synopsis

The aim of this user-focused monitoring of mental health services was to discover the views of service users about the services that they received. When I reflected on this I began to wonder why such research was needed. Had users' views been excluded from service development in the past?

Fifty-eight people who were currently using the service agreed to participate. All were deemed to be amongst 'the most vulnerable' (p. 5). However, as they were all recruited via their key workers, I was left wondering if this was the best way to ensure that the broadest range of evaluative responses were obtained, or whether the key workers would have acted as filters.

A team of users were used as evaluators, carrying out site visits and interviews. However, the Quality Assurance Team at the Sainsbury Centre created the semi-structured interview schedule used. Although the schedule went through re-drafting in light of discussion with the user evaluators, it was still apparently driven by an agenda that was not user created.

The results of the interviews threw up some startling issues. For example: around half of the participants did not know who to contact in times of crisis and more than 40% did not know that they had a care plan. Nearly two thirds of interviewees lacked satisfaction with the service provided by all the professionals involved in their care. Of the participants 38% rated themselves as overmedicated and almost 70% rated themselves at three or above on a one to five scale of distress for side effects of medication, where one was 'slight distress' and five was 'very distressing'.

Perhaps this project did lead to change. The authors state that 'a great deal of feedback has been received and we have assurances that services will change in line with users' views expressed in this project' (p. 3). However, my own past experience and thoughts of my friends who, although having been told in the past that their views mattered, were subjected to treatments and medications against their will, have led me to feel a touch cynical at such a bold assertion.

Perhaps this research has given some people a voice. Yet if I were given such a voice, I would ask if this was just tokenism? I would ask if there had been any subsequent User Focused Monitoring of Mental Health Services in Kensington and Chelsea and Westminster Health Authority. I would ask who had benefited from this research: users, service providers, research coordinators, the Sainsbury Centre for Mental Health? I would also ask why there was no mention of recovery and whose interests were served by such omission? I cannot help thinking that although this may have been neatly staged piece of research, by and with and for the oppressed, it did little to effect change to the oppression that was then and is currently experienced by users of mental health services.