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’.

No Joke: Understanding Public Sentiment Toward Selling and Salespeople Through Cartoon Analysis

Unflattering representations of salesmanship in mass media exist in abundance. In order to gauge the depiction of selling in mass media, this article explores the nature and public perceptions of salesmanship using editorial cartoons. A theory of cartooning suggests that editorial cartoons reflect public sentiment toward events and issues and therefore provide a useful way of measuring and tracking such sentiment over time. The criteria of narrative, location, binary struggle, normative transference, and metaphor were used as a framework to analyze 286 cartoons over a 30-year period from 1983 to 2013. The results suggest that while representations of the characteristics and behaviors of salespeople shifted very little across time periods, changes in public perceptions of seller–buyer conflict, the role of the customer, and selling techniques were observed, thus indicating that cartoons are sensitive enough to measure the portrayal of selling.

Interface of the Environment and Occurrence of Botrytis cinerea in Pre-symptomatic Tomato Crops

Botrytis cinerea (Grey mould) is a necrotrophic fungus infecting over 230 plant species worldwide. It can cause major pre- and post-harvest diseases of many agronomic and horticultural crops. Botrytis cinerea causes annual economic losses of 10–100 billion US dollars worldwide and instability in the food supply (Jin and Wu, 2015). Grey mould losses, either at the farm gate or later in the food chain, could be reduced with improved knowledge of inoculum availability during production. In this paper, we report on the ability to monitor Botrytis spore concentration in glasshouse tomato production ahead of symptom development on plants. Using a light weight and portable air sampler (microtitre immunospore trap) it was possible to quantify inoculum availability within hours. Also, this study investigated the spatial aspect of the pathogen with an increase of B. cinerea concentration in bio-aerosols collected in the lower part of the glasshouse (0.5 m) and adjacent to the trained stems of the tomato plants. No obvious relationship was observed between B. cinerea concentration and the internal glasshouse environmental parameters of temperature and relative humidity. However the occurrence of higher outside wind speeds did increase the prevalence of B. cinerea conidia in the cropping environment of a vented glasshouse. Knowledge of inoculum availability at time periods when the environmental risk of pathogen infection is high should improve the targeted use and effectiveness of control inputs.