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Worldwide, there has been a growth in service user involvement in education and research in recent years. This handbook is the first book which identifies what is happening in different regions of the world to provide different countries and client groups with the opportunity to learn from each other. The book is divided into five sections: Section One examines service user involvement in context exploring theoretical issues which underpin service user involvement. In Section Two we focus on the state of service user involvement in human services education and research across the globe including examples of innovative practice, but also identifying examples of where it is not happening and why. Section Three offers more detailed examination of such involvement in a wide range of professional education learning settings. Section Four focuses on the involvement of service users in research involving a wide range of service user groups and situations. Lastly, Section Five explores future challenges for education and research to ensure involvement remains meaningful. The book includes forty-eight chapters, including seventeen case-studies, from all regions of the world, this is the first book to both highlight the subject's methodological and theoretical issues and give practical examples in education and research for those wishing to engage in this field. It will be of interest to all service users, scholars and students of social work, nursing, occupational therapy, and other human service subjects.

Previous research has shown that experiential knowledge plays an important role for service user movements and has also discussed ambiguities in the definition of this type of knowledge. This study contributes to clarifying how experiential knowledge is understood within the service user movement. Through semi-structured interviews, it explores how Swedish mental health service user organisations (MHSUOs) and service user entrepreneurs (SUEs) regard the role of experiential knowledge for their endeavours. The study shows that SUEs and MHSUOs view experiential knowledge as complementary to established medical and expert knowledge. Both groups further reflect on the functions of individual and collective dimensions of experiential knowledge. Emotions are important in conveying experiential knowledge, although emotional commitment can be short-lived. The study discusses challenges for SUEs and MHSUOs in developing strategies to manage risks tied to strategic essentialism, and also in maintaining a critical standpoint towards established service providers.

Understanding of the benefits of consumer-led health policy, practice, research and education has been developing for decades. However, barriers to genuine, non-tokenistic consumer leadership remain across the health sector. While recent calls to align Australian consumer engagement practices with those in the UK and elsewhere may sound progressive, doing so would be problematic for three reasons. First, Australia has been at the forefront of consumer leadership scholarship and advocacy for decades, and we should not ignore the work consumers and allies have done in improving our health systems. Second, although there have been positive outcomes from consumer engagement and inclusion practices (as often required in other jurisdictions), they are open to tokenism and continue to position consumers’ experiential expertise as ‘lesser’ compared to other health sector stakeholders’ knowledge. Last, compared to consumer leadership, engagement or inclusion are ‘lower bars’ for health professionals to aim for. If we settle for engagement or inclusion in cases where consumer leadership would have been possible, then we lose not only our position at the forefront of consumer leadership, but also the expertise of consumers. Three propositions are provided: (1) we should support consumer-led development policy for consumer leadership in health, (2) we should ensure consumer leadership in oversight over as well as conduct of health and medical research, (3) we should encourage honest claims about the extent to which projects or initiatives are led by or with consumers.

Background Less than 20% of youth who experience mental health difficulties access and receive appropriate treatment. This is exacerbated by barriers such as stigma, confidentiality concerns and lack of mental health literacy. A youth team developed the Wellness Quest: a health literacy tool to enable help‐seeking youth to advocate for themselves. Objective To evaluate the content, presentation and utility of the Wellness Quest tool among youth. Participants Participants aged 14 to 26. Methods A youth research team conducted five focus groups and one online survey to evaluate the Wellness Quest tool. Thematic analysis was used to analyse the qualitative data, and descriptive statistics were used to explore the survey results. Main results Overall evaluations of the Wellness Quest were positive: participants felt it would be useful during their mental health help‐seeking journey. Participants expressed the need for information about services for specific populations, such as Indigenous, immigrants, refugees and 2SLGBTQ + youth. They expressed that the tool should be available in complementary online and print versions. Discussion Improving mental health literacy may improve mental health by enabling youth and those who support them to recognize and respond to signs of distress and understanding where and how to get help. The Wellness Quest tool may equip youth with the knowledge to make informed decisions and advocate for their own mental health, thereby facilitating help‐seeking among youth. Patient or public contribution Youth as service users led all stages of the project, from designing and conducting the study and analysing the data to writing the manuscript.

Patients with mental health diagnoses (MHD) are among the most frequent emergency department (ED) users, suggesting the importance of identifying additional factors associated with their ED use frequency. In this study we assessed various patient sociodemographic and clinical characteristics, and service use associated with low ED users (1-3 visits/year), compared to high (4-7) and very high (8+) ED users with MHD. Our study was conducted in four large Quebec (Canada) ED networks. A total of 299 patients with MHD were randomly recruited from these ED in 2021-2022. Structured interviews complemented data from network health records, providing extensive data on participant profiles and their quality of care. We used multivariable multinomial logistic regression to compare low ED use to high and very high ED use. Over a 12-month period, 39% of patients were low ED users, 37% high, and 24% very high ED users. Compared with low ED users, those at greater probability for high or very high ED use exhibited more violent/disturbed behaviors or social problems, chronic physical illnesses, and barriers to unmet needs. Patients previously hospitalized 1-2 times had lower risk of high or very high ED use than those not previously hospitalized. Compared with low ED users, high and very high ED users showed higher prevalence of personality disorders and suicidal behaviors, respectively. Women had greater probability of high ED use than men. Patients living in rental housing had greater probability of being very high ED users than those living in private housing. Using at least 5+ primary care services and being recurrent ED users two years prior to the last year of ED use had increased probability of very high ED use. Frequency of ED use was associated with complex issues and higher perceived barriers to unmet needs among patients. Very high ED users had more severe recurrent conditions, such as isolation and suicidal behaviors, despite using more primary care services. Results suggested substantial reduction of barriers to care and improvement on both access and continuity of care for these vulnerable patients, integrating crisis resolution and supported housing services. Limited hospitalizations may sometimes be indicated, protecting against ED use.

Context Despite a growing interest in service‐user involvement in mental health services, the interaction between health institutions and local groups is only beginning to receive attention, particularly in global south settings. Objective Looking at a participatory initiative in Chile, this study explores how, under unfavourable administrative conditions, health organizations approach and work with communities. Methods We interviewed policy‐makers (5), local professionals (10), service users and community representatives (6) linked to a concrete participatory initiative. Participant observation in relevant meetings helped to enrich the interpretations. Thematic analysis was applied to interview transcripts and field notes. Findings The findings present a sequence of actions starting with the creation of a network of community‐based groups. A set of problems ensued, related to the group's diversity, internal representation, decision‐making and funding processes. In response, processionals implemented simultaneously bureaucratic and democratic adjustments, developing a vision of community that ignored the particularities—including the motivations—of local groups. Discussion and conclusion Based on these findings, we argue that participatory initiatives should be studied as on‐going achievements shaped by broad policy orientations and local configurations of interest. In the process, they produce ad hoc forms of knowledge and visions of community that provide orientation to the agents involved.

Drawing upon commitmentâ-\"trust theory and the investment model, this study constructed a research model for understanding the mechanism of mobile online-to-offline (O2O) service users' continuance usage intention. Results from a survey of 299 O2O users in China revealed that users' trust was positively related to their commitment, habit, and continuance usage intention, and negatively related to the perceived attractiveness of alternative vendors. Further, users' commitment was positively related to their habit and continuance usage intention, and negatively related to the attractiveness of alternative vendors. Finally, users' habit was positively correlated with their continuance usage intention, and the attractiveness of alternative vendors was negatively correlated with continuance usage intention. This study provides a new perspective inspired by the investment model to understand the antecedents of continuance usage intention of mobile O2O services.

Background Extensive research effort shows that weight management programmes (WMPs) targeting both diet and exercise are broadly effective. However, the critical features of WMPs remain unclear. Objective To develop a deeper understanding of WMPs critical features, we undertook a systematic review of qualitative evidence. We sought to understand from a service‐user perspective how programmes are experienced, and may be effective, on the ground. Search strategy We identified qualitative studies from existing reviews and updated the searches of one review. Inclusion criteria We included UK studies capturing the views of adult WMP users. Data extraction and synthesis Thematic analysis was used inductively to code and synthesize the evidence. Main results Service users were emphatic that supportive relationships, with service providers or WMP peers, are the most critical aspect of WMPs. Supportive relationships were described as providing an extrinsic motivator or “hook” which helped to overcome barriers such as scepticism about dietary advice or a lack confidence to engage in physical activity. Discussion and conclusions The evidence revealed that service‐users’ understandings of the critical features of WMPs differ from the focus of health promotion guidance or descriptions of evaluated programmes which largely emphasize educational or goal setting aspects of WMPs. Existing programme guidance may not therefore fully address the needs of service users. The study illustrates that the perspectives of service users can reveal unanticipated intervention mechanisms or underemphasized critical features and underscores the value of a holistic understanding about “what happens” in complex psychosocial interventions such as WMPs.

Objective To synthesize the qualitative literature on adults’ experiences of psychological therapy assessments. The review was led by people with experience of undergoing assessments, with high levels of client involvement throughout. Search strategy A comprehensive search of electronic databases was undertaken, with additional search strategies employed to locate further literature. Inclusion criteria Studies were included that qualitatively explored the experiences of people aged 16+ who had been assessed for psychological therapy services. Assessments could be structured or unstructured. Qualitative was defined as any analysed account of people's experiences, including qualitative survey data. Data extraction and synthesis Literature quality was appraised using the Critical Appraisal Skills Program checklist, modified to include client involvement and intersectionalities. Following data extraction, thematic synthesis was used to synthesize findings across studies. Results Of 12 743 titles were screened, with 13 studies relevant to the review. Themes and subthemes were identified at three stages of the assessment process: the journey to the assessment, at the assessment, and after the assessment. Findings highlighted the emotional impact of assessments, collaboration, intersectionalities, rights, pathologization, socioeconomic restrictions, and information and support needs. Implications and limitations were indicated. Discussion and conclusions Findings were situated within the trauma‐informed (TIA) literature. Trauma‐informed assessment principles, including collaborative assessments, may be fruitful means of improving people's experiences. Whilst the benefits of collaboration appear self‐evident, explicitly collaborative approaches were not the norm, nor were studies conducted independently. Further service user research is needed. A greater understanding of the experience of minority groups is also needed.

Background Involvement of service-users at all levels of the mental health system is a policy imperative in many countries internationally. However, putting policy into practice seems complex; little is known about how best to involve service users and efforts are often criticized for being tokenistic. In low-and-middle income countries, less attention has been given to the roles of service users within mental health systems. The proposed study is part of a larger project intended to develop service-user involvement in mental health system strengthening in Ethiopia. A Theory of Change (ToC) model has already been developed through a participatory approach. This study protocol aims to describe the theoretical background and methods to pilot this model using participatory action research (PAR) and explore participants’ experience of involvement. Methods The proposed study will apply a PAR approach situated in critical social theory and conduct a phenomenological case study to find out participants’ experience of involvement. This will be conducted in three stages. The focus of Stage 1 will be to(i) establish a Research Advisory Group (RAG), and Research Participant Group (RPG) at district and primary healthcare facility levels, respectively, and (ii) identify and prioritize potential areas of concern for involvement in the domains of advocacy, service planning and development, monitoring and improving service quality. In Stage 2, we will work with the RPG to develop a plan of action for the selected area. Stage 3 will aim to assist the RPG to implement and evaluate the plan of action. Process indicators and observation will be combined with in-depth interviews with participants to elicit their experiences of involvement. Thematic content analysis will be used. Discussion The participatory approach to mental health service user involvement in health system strengthening employed by this study will support the implementation of solutions through locally relevant and contextualized actions. Findings from this study will contribute to the body of knowledge towards understanding the complexity of implementation of service user involvement and refine the ToC model for transferability to similar settings.