The Carmarthenshire, Ceredigion and Pembrokeshire Mental Health User Involvement Working Group comprises service user representatives, WWAMH, LHBs and the Hywel Dda Local Health Board.

We have produced this Good Practice Guide is for all those committed to genuine service user and carer involvement.  It concentrates on the involvement of service users in the planning process of mental health services. Involvement in planning individual packages of care is being developed through the Care Programme Approach.

In line with Standard 2 of the Adult Mental Health Services NSF, this document informs and support’s service user & carer involvement in the planning, commissioning, delivery, monitoring and evaluation of mental health services at a collective and strategic level

What follows is an Executive Summary:

WHAT IS INVOLVEMENT?
• Service users should have a say in the development of services they use.
• Service users have invaluable experience and expertise to share with professionals.
• Service user involvement should be based on respect, equity and the valuing of input.
• User involvement is not free.  A culture needs to be developed which establishes realistic levels of funding.
BACKGROUND

Legislation and strategic documents drive this policy.
• The benefits of service user participation in mental health services in Wales have been widely recognised, and have been present in Pembrokeshire, Ceredigion and Carmarthenshire for some time.
• Empowerment is one of the 4 key principles of the NSF.
• Stronger in Partnership offers a guide to involvement; this document seeks to flesh that out.
• NSF, Key Action 7 says “By March 2006 in line with ‘Stronger in Partnership,’ the NHS and Local Authorities must have introduced arrangements to ensure that service users and carers are meaningfully involved in the planning, design, delivery and monitoring and evaluation of mental health services”.

VALUES
• Service user involvement is integral and not an add-on.
• Involving service users reduces stigma in society.
• Everyone needs to know they have a part to play in involving service users.
• Service users should be supported practically, emotionally and financially to take part in involvement.
• Service user representation requires robust and transparent consultation with a wide range of service users.
IMPLEMENTATION
• Service users must be involved in the formal structures as full and equal partners.
• Existing service user groups and forums need to be strengthened by service user and carer development workers or equivalents.
• New innovative systems require to be developed to enable service users to fulfil their responsibilities within joint working and partnerships.
• Independently facilitated ward meetings or patient councils, should be available on all wards with an independent facilitator.
RECRUITMENT OF STAFF

The Working Group wishes to implement a targeted approach to the involvement of service users in recruitment at all levels.
• A rolling programme of training for service users should be in place.
• A database of service users is needed to ensure that those willing to be involved in recruitment processes will be established.
MONITORING, AUDIT & RESEARCH
• Each organisation and planning structure should be able to demonstrate how services are performing against standards set at both national and local levels.
• Service users should be supported to participate in this process.
• Involvement of service users in monitoring and audit demonstrates a commitment to continuous improvements and needs to be strengthened.

SERVICE USERS & STAFF TRAINING
• Service Users should be involved in multi agency training, e.g. as speakers / workshop leaders at conferences, etc.
• We need a policy for service user involvement in staff training.
• Training should be made available for service users to be involved in staff training at all levels.  Pontydd has been very active in the Three Counties training a range of agencies.
• Funding should be made available to cover all costs incurred by service user in the delivery of training.

SERVICE USERS AS EMPLOYEES OF MENTAL HEALTH SERVICES
• Employment may not obviously fall within the Public Patient Involvement agenda but it does contribute to an open culture of acceptance and reduces stigma.
• The culture within mental health services needs to change to make it acceptable for employees to be open about their experiences.
• The Working Group supports the development of a specific service user employment programmes to actively encourage mental health service users to apply for positions.
TRAINING STAFF IN INVOLVEMENT
• Service user issues and involvement should be a core component of all induction training.
• Staff in all Mental Health Services should be encouraged to attend an annual ‘update’ training session on user involvement.
INVOLVING HARD TO REACH SERVICE USERS
• Services tend to rely on established user groups and a small number of committed representatives. Many people using mental health services do not want to be involved in structured activity, and may have limited awareness regarding involvement activities.
• The Working Group recommends the establishment of well advertised suggestions and concerns box at all service delivery locations.
• Service user conferences should be held annually.
• Open meetings held to inform and consult with service users.
• All service users should be given an opportunity to complete exit questionnaires or testimonials on discharge from the services.
• Specific issue service user panels organised when comment and consultation is needed.
HOW SERVICE USERS ARE ENABLED.
• There is currently no formal induction for service users.
• Many service users have taken advantage of training courses offered locally by the voluntary sector such as Pontydd.
• Any training within agencies that would benefit service users should be made available as a matter of course.
• Appropriate resources should be available to offer annual training programme for service users in an ‘involvement role’.
• Access to up to date information is central to the meaningful involvement of service users.
• Adequate support and assistance must be provided to Service Users and Service user groups.

RECOMPENSE.
• No service user who is asked to become involved in Mental Health Service business should be out of pocket as a result.
• Where agencies ask for involvement from service users all out of pocket costs will be paid, including costs relating to preparation and follow up work.
• Support, advice and information should be provided in relation to benefits and finance.
• More consistent and appropriate levels of funding for Service User groups to reflect the value of Service user Involvement.