Reflexivity and participation in communities CZ

This visit focused on a Psychiatry of Later Life service that serves the local catchment area for individuals who are over 65 and who have complex mental health problems such as people with dementia who have particular responsive behaviours or other mental health conditions such as depression, bipolar disorder or schizophrenia.

The service is a publicly provided service that is medically led, and patients are referred by medical practitioners. The initial assessment includes social workers, nurses, and psychologists and the service has a strong multidisciplinary teamwork focus with perceived mutual respect between team members.

A philosophy of the service is ‘Recovery through activity (what a person does for well-being)’ utilising a ‘RAP’ approach- planning for wellness and recovery, educational courses find out what people want to engage the right people — knowing that it is difficult to change culture, it's important to educate the professionals. Connection, being connected with, hope, identity, purpose and meaning of life, empowerment = Chine framework (Leany, 2011).

The service is also characterised by an emphasis on moving the knowledge stream and co-production, embracing the national approach for recovery in mental health (clinician, service user (SU), support person). This centres on four principles:

1. SU – Center
2. Everything concerning services is co-produced
3. Organizational commitment (working with the management team, with SU when revising or forming a new policy)
4. Recovery learning and practice are supported by others or co-production in practice.

The visit explored the question, what is recovery education? Principles such as co- produced adult educational model, experiential education model, values lived experience, increases the capacity in services and student, facilitated peer support, strength-based staff approach.

The service employs service users and 3% of the mental health staff comprises of service users. Some risks associated with this include peers becoming professionalized. Activities versus literacy – reflection - how we come together, what are the important aspects of working together? Reference is also made to Arnstein’s (1969) Ladder of Citizen Participation. Time was highlighted as a constant challenge to participation and coproduction.

What is important? Process and context; good communication skills and there always must be a presence of a peer group (organic, strong base).

Three faces: Engagement – Implementation-Transformation.