Mental health: designing and delivering services with the public

Person-centred care is fundamental to mental health provision, empowering people to take charge of their own health and behaviours through understanding and collaboration, rather than enforcement.

Healthcare professionals may be experts by training, but patients and carers are experts by experience.

Mental health is one of the most prominent issues in healthcare today. From my experience of working in mental health, I’ve come to learn that person-centred care is essential to empowering individuals to work towards recovery.

What is person-centred care?

There are various definitions of person-centred care. The Health Innovation Network South Londonexplains it concisely:
‘Person-centred care is a way of thinking and doing things that sees the people using health and social services as equal partners in planning, developing and monitoring care to make sure it meets their needs. This means putting people and their families at the centre of decisions and seeing them as experts, working alongside professionals to get the best outcome.’
  Person-centred care is not a new concept. National guidelines – such as National Institute for Health and Care Excellence (NICE) guidance in the UK – state the importance of person-centred care in caring for people with mental health conditions. However, understanding of person-centred care, such as common definitions and guidance on implementing it in practice – is not well established. This can result in scepticism and tokenistic engagement of patients and carers.

Experts by experience

Healthcare professionals may be experts by training, but patients and carers are experts by experience. Given that they are the ones for whom the service exists, we should be listening to them about what they want and need.

It is not enough to consult these experts by experience as a second thought – they need to be involved in the decision-making process from the beginning. The views of clinicians and policymakers on what is important to a person’s recovery might be worlds apart from that person’s own perspective. Involving experts by experience at every level of decision-making ensures that the service on which we are spending money is actually beneficial to those whom it is for.

Gellinudd Recovery Centre: co-designing a mental health service

In Wales, a mental health centre recently opened that has been co-designed and co-delivered with experts by experience. Designing the centre took three years of consultations – the experts by experience met with the architects and designers throughout the process, and were involved in the development of the centre’s holistic approach. Gellinudd Recovery Centre is a great example of meaningful engagement and person-centred care.

Guests and staff at the centre meet regularly, to develop and evaluate the service and their holistic approach. This approach looks at work, relationships, finance, sociocultural and spiritual beliefs, education, accommodation, medical and psychological interventions, and wellbeing.

Empowering people to take charge of their own health status and behaviours is both ethically advantageous and cost-effective.

Person-centred care in all health policy

Empowering people to take charge of their own health status and behaviours is both ethically advantageous and cost-effective. Studies have shown that improving individuals’ self-management and involving them in shared decision-making can lead to reductions in future service usage.

Person-centred care and meaningful engagement with people who are experts by experience should be a staple of all health policy and practice. Mental health, obesity, heart disease, diabetes and cancer are today’s – and tomorrow’s – major global health concerns. These conditions are associated with certain behaviour patterns linked with individuals’ wellbeing, environment, resilience and support systems.

There are numerous positive public health interventions, such as tobacco control, alcohol minimum pricing, and taxes on high-sugar food and drink. But these should be part of a package of interventions that focus on empowering people to change their behaviours for themselves – and not just because an unhealthy lifestyle costs more.

This goes beyond the traditional health promotion tools of taxation, information provision, legislation and so on. We need more research and investment in designing services that involve people, and allow individuals to be involved in every step of the decision-making process. This will allow everyone to be an active contributor to not only their own health, but also the wider healthcare system and overall environment.

To read more about this topic:

The Health Policy Partnership has published previously on mental health, person-centred care and public involvement in health. See the relevant sections on our Publications page, or read our global synthesis report on The state of play in person-centred care.

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The opinions expressed in this blog are those of the individual authors and do not represent the views of The Health Policy Partnership.