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’.

Bridging the Divide in Work and Occupational Psychology: Evidence From Practice

This study explores the extent to which work and organizational (W&O) psychology practitioners use evidence, how they apply it to the everyday contexts in which they work and the types of barriers they encounter in so doing. It adopts a mixed methods approach involving the administration of a survey to a UK sample (N=163) of W&O psychologists and a series of semi-structured interviews (N=25) exploring in greater depth how evidence is applied in practice. Findings reveal that practitioners consult a wide range of different types of evidence which they employ at various stages of engagement with client organisations and that this evidence is pressed into service in the pursuit of solutions which are both acceptable from the client perspective and consistent with the scientific standards underpinning professional knowledge and expertise in W&O psychology. Barriers to evidence-use were mainly practical in nature, concerning issues around managing the client-consultant relationship and the particularities of implementation context, both of which were shown to influence evidence utilisation. The study contributes to current debate on the extent to which W&O psychologists adopt an evidence-based approach and provides a valuable and much called-for empirical insight into the enactment of the scientist-practitioner model in W&O psychology

The Path between Pedagogy and Technology: Establishing a Theoretical Basis for the Development of Educational Game Environments

The power of computer game technology is currently being harnessed to produce “serious games”. These “games” are targeted at the education and training marketplace, and employ various key game-engine components such as the graphics and physics engines to produce realistic “digital-world” simulations of the real “physical world”. Many approaches are driven by the technology and often lack a consideration of a firm pedagogical underpinning. The authors believe that an analysis and deployment of both the technological and pedagogical dimensions should occur together, with the pedagogical dimension providing the lead. This chapter explores the relationship between these two dimensions, and explores how “pedagogy may inform the use of technology”, how various learning theories may be mapped onto the use of the affordances of computer game engines. Autonomous and collaborative learning approaches are discussed. The design of a serious game is broken down into spatial and temporal elements. The spatial dimension is related to the theories of knowledge structures, especially “concept maps”. The temporal dimension is related to “experiential learning”, especially the approach of Kolb. The multi-player aspect of serious games is related to theories of “collaborative learning” which is broken down into a discussion of “discourse” versus “dialogue”. Several general guiding principles are explored, such as the use of “metaphor” (including metaphors of space, embodiment, systems thinking, the internet and emergence). The topological design of a serious game is also highlighted. The discussion of pedagogy is related to various serious games we have recently produced and researched, and is presented in the hope of informing the “serious game community”.