A collaborative study on user participation in mental health services : east meets west

Abstract

User participation in mental health services is seen as a significant pathway towards the outcomes of recovery and empowerment, service improvement and the cornerstone of recovery-oriented care. This collaborative and experiential study adopted the constructivist grounded theory approach to explore the meaning, process and experiences of user participation in the mental health services of Hong Kong from the service users’ perspective. The collaborative research team was formed with the author, persons with lived experience of mental illness and veteran researchers in mental health. Data were collected through multiple qualitative methods with participants responding in focus groups, individual in-depth interviews and photovoice. Data analysis was conducted following the constructivist grounded theory method.

Findings of the study highlighted the complex multi-relational contexts and the interactional dynamics impacting the enactment and outcomes of user participation in mental health services. They also identified the orientation of self-management towards recovery goals and personal wellbeing for user participation in contrast to that of rights and citizenship. Moreover, service users valued professional facilitation in advancing user involvement in the operational and strategic levels. The findings thus expanded the existing conceptualization of user participation in mental health services to embed the multi-relational, collaborative and non-rights based orientation. Discussion was given to caution against adopting the Western ideologies of the notion regardless of the cultural characteristics in the current context.

The participatory approach of the study also sheds light on the positive effects of autonomous and genuine participation. Practice guidelines on channels and platforms for access to information and knowledge, open dialogues, training and supervisory support for practitioners, development of formal peer support and peer leadership, resource commitment from the mental health system, and government policy are proposed to foster effective and meaningful participation of mental health service users in Hong Kong.