A meta-ethnography of factors contributing to a positive experience for those within mental health peer support roles, and A grounded theory analysis exploring the processes of readiness for initial and sustained involvement for service users involved in mental health co-production activities

Patton, Diane 2022. A meta-ethnography of factors contributing to a positive experience for those within mental health peer support roles, and A grounded theory analysis exploring the processes of readiness for initial and sustained involvement for service users involved in mental health co-production activities. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

In recent years organisations have recognised the value and importance of embedding coproduction within mental health services. Co-production in mental health settings refers to a process in which service users, carers and staff work together as equal partners towards shared goals (Social Care Institute for Excellence, 2015). Relating to the term co-production are various levels of peer involvement, with roles including ‘Expert by Experience’ and ‘Peer Support Worker’, as well as initiatives such as ‘Service User Networks’ and ‘Recovery Colleges’. As co-production has become more common practice, there has been an increase in research in the field. Much of the research to date has explored implementation issues and barriers faced as mental health services move towards this new way of working. Whilst this research is valuable, much of the research overlooks the importance of ascertaining the perspectives of the individuals employed in such roles or focuses on identifying the challenges faced within roles. This thesis places its focus on the individuals engaging in coproduction activities in two ways; firstly, by exploring through a systematic review of the literature to identify what has contributed to a positive appraisal of involvement for individuals within roles, and secondly by describing an empirical investigation of the processes involved in initial readiness and subsequent sustained involvement in coproduction activities. Paper one presents a qualitative meta-synthesis employing the method of meta-ethnography to synthesise and present the data. The systematic review aimed to provide new insights and a conceptual model related to the factors that contribute to a positive experience for those providing a peer support role in a mental health setting. A systematic literature search resulted in twelve studies meeting the agreed inclusion criteria. Studies were subsequently quality assessed. Through following the processes of meta-ethnography, three core concepts of ‘organisational processes’, ‘internal processes’ and ‘relational processes’ were identified. Within the core concept of ‘organisational practices’ were the subordinate concepts of ‘clear avenues of support’, ‘commitment within the system’, ‘clear role structure and responsibilities’ and ‘professional development opportunities’. Within the core concept of ‘internal processes’ were the subordinate concepts of ‘feeling trusted to work autonomously’, ‘personal development and growth’ and ‘sense of making a difference’. Finally, the concept of ‘relational factors’ encompassed the subordinate concepts of ‘positive interactions with staff’, ‘integration within the team’ and ‘connection with those in similar roles’. The findings of the review have implications for clinical practice, with organisations needing to consider how they integrate individuals within the immediate and wider system, as well as considering how they provide sufficient opportunities for personal and professional development. Paper two presents a grounded theory analysis exploring the processes underlying individual readiness for involvement in co-production roles, as well as considering factors influencing their sustained involvement. Within the current co-production research literature, there has been limited exploration of factors involved in peer readiness for involvement and the processes that may underlie this. The current study aimed to use the insight gained to develop a theory that can be used to inform the development of guidance around supporting individuals to become and remain involved in roles outside of their own care. Ten individuals recently involved in co-production activities completed semi-structured interviews. Analysis of data was conducted using a constructivist grounded theory methodology. The emerging theoretical model described several key processes that individuals navigate prior to, and subsequently during, their journey into co-production activities. Individuals’ initial motivation for considering involvement was found to be an important component of their journey to readiness. Motivating factors were shaped by participants’ previous 8 experiences of mental health services and often involved a sense of desiring change, both within the mental health system and within their own identity. Processes involved in readiness included: ‘building awareness of own mental health’, ‘desire for personal growth’ and ‘recognition of their own potential’. Perceived readiness for involvement was also deemed to be influenced by a range of external factors, with particular importance being placed on organisations providing opportunities for meeting with others in similar roles, as well as roles that allow for ‘graded exposure’ to clinical activities. Wider influences on individuals and the process of becoming ‘ready’ were identified, with normalisation of mental health within organisations emerging as a key concept. With regards to ongoing involvement in activities, participants discussed a variety of positive and negative aspects of experiences that influenced this decision. Recommendations for clinical practice are discussed, specifically the need for organisations to provide individuals with opportunities to meet others in role prior to involvement and to provide clarity within roles. Importantly, the research identifies a need for organisations to demonstrate commitment to providing a work environment that clearly acknowledges the value and importance of learning from and working with individuals throughout their recovery journey.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2022
Last Modified:	05 Jan 2024 08:26
URI:	https://orca.cardiff.ac.uk/id/eprint/152751

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