Participation in Mental Health Services: The Forgotten Bit

In the literature and in government documents 'participation in mental health services' refers to participation in one's own care and treatment, the rights of family to participate in the care and treatment of the person living with mental illness and, the right for consumers and family to participate in decision-making about how to improve our mental health services. A raft of government standards support participation and consumers and family members say they want it. What this means is that consumers and family members must be sitting alongside mental health managers and clinicians on recruitment panels and at clinical governance and policy committee meetings. It means that consumers and family members must have a say about how a mental health service manages the use of medication, seclusion and restraint of patients. And it means that consumers, family members, managers and clinicians jointly decide whether a service needs to grow, where a new service is to be located to meet community need and what the design of the service looks like.

Participation is about an equal relationship between mental health professionals, consumers and family members. But of course equality is difficult when health professionals hold a position of expertise of mental health problems and service delivery and if consumers and family members argue a case for expertise through lived experience. What must be remembered and kept central in this scenario is why participation is important in the first place. Participation has been on the agenda for over thirty years and was fought for by consumers and family members advocating against institutional abuse of patients in mental health services. Governments across the world have since acknowledged the problem of institutional abuse and supported participation. Preventing current and future abuse of vulnerable people living with mental illness must be the central reason why we strengthen and grow participation.