Carers and Co-Production: Enabling Expertise through Experience?

Purpose To provide a brief overview of the literature to date which has focussed on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision-making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research Limitations Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical Implications Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the ‘triangle of care’ with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social Implications The families of people with severe and enduring mental illness (SMI) assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al, 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The ‘co-production of care’ reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the ‘triangle of care’ with carers bringing their own skills, resources and expertise. Originality/Value This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a ‘triangle of care’.

Creating Educational Immersive Environments Using a Computer Game Engine: Case Studies and Design Theory

This paper aims to crystallize recent research performed at the University of Worcester to investigate the feasibility of using the commercial game engine ‘Unreal Tournament 2004’ (UT2004) to produce ‘Educational Immersive Environments’ (EIEs) suitable for education and training. Our research has been supported by the UK Higher Education Academy. We discuss both practical and theoretical aspects of EIEs. The practical aspects include the production of EIEs to support high school physics education, the education of architects, and the learning of literacy by primary school children. This research is based on the development of our novel instructional medium, ‘UnrealPowerPoint’. Our fundamental guiding principles are that, first, pedagogy must inform technology, and second, that both teachers and pupils should be empowered to produce educational materials. Our work is informed by current educational theories such as constructivism, experiential learning and socio-cultural approaches as well as elements of instructional design and game principles.

The Role of Art in Computer Game Design

Computer games are significant since they embody our youngsters’ engagement with contemporary culture, including both play and education. These games rely heavily on visuals, systems of sign and expression based on concepts and principles of Art and Architecture. We are researching a new genre of computer games, ‘Educational Immersive Environments’ (EIEs) to provide educational materials suitable for the school classroom. Close collaboration with subject teachers is necessary, but we feel a specific need to engage with the practicing artist, the art theoretician and historian. Our EIEs are loaded with multimedia (but especially visual) signs which act to direct the learner and provide the ‘game-play’ experience forming semiotic systems. We suggest the hypothesis that computer games are a space of deconstruction and reconstruction (DeRe): When players enter the game their physical world and their culture is torn apart; they move in a semiotic system which serves to reconstruct an alternate reality where disbelief is suspended. The semiotic system draws heavily on visuals which direct the players’ interactions and produce motivating gameplay. These can establish a reconstructed culture and emerging game narrative. We have recently tested our hypothesis and have used this in developing design principles for computer game designers. Yet there are outstanding issues concerning the nature of the visuals used in computer games, and so questions for contemporary artists. Currently, the computer game industry employs artists in a ‘classical’ role in production of concept sketches, storyboards and 3D content. But this is based on a specification from the client which restricts the artist in intellectual freedom. Our DeRe hypothesis places the artist at the generative centre, to inform the game designer how art may inform our DeRe semiotic spaces. This must of course begin with the artists’ understanding of DeRe in this time when our ‘identities are becoming increasingly fractured, networked, virtualized and distributed’ We hope to persuade artists to engage with the medium of computer game technology to explore these issues. In particular, we pose several questions to the artist: (i) How can particular ‘periods’ in art history be used to inform the design of computer games? (ii) How can specific artistic elements or devices be used to design ‘signs’ to guide the player through the game? (iii) How can visual material be integrated with other semiotic strata such as text and audio?