ABSTRACT
Service users' involvement in mental health service research is increasingly acknowledged as important, yet, whilst involving users of mental health services as research participants is commonplace, seeking out their experience and indeed their "expertise" to facilitate the development of tools to be used within mental health services is in its infancy. This article describes the involvement and views of service users in the development of a nursing metric-the Therapeutic Engagement Questionnaire. It presents their role in the three stages of development: generation, statement reduction and authentication.
Subject(s)
Mental Disorders/therapy , Mental Health Services/organization & administration , Nurses/psychology , Patient Participation/psychology , Psychiatric Nursing , Surveys and Questionnaires/standards , Health Services Research/organization & administration , Humans , Patient Satisfaction , Reproducibility of ResultsABSTRACT
Drawing on psychodynamic and managerialist concepts, this paper explores possible consequences for patients and mental health nurses of the policy driven "splitting" of mental health service provision in the UK. Services and resources are now split for those with a severe and enduring mental illness and those with a common mental problem. We argue the damaging divisiveness in creating these two "political" groups makes determining how to meet the needs of individuals with common yet complex problems more difficult. The way in which an increased awareness and understanding of psychodynamic concepts can help the mental health nurse deal with such complexity is explored.
Subject(s)
Health Policy , Insurance, Nursing Services , Mental Disorders/nursing , Mental Health Services , Psychiatric Nursing/organization & administration , State Medicine/organization & administration , Chronic Disease , Humans , Nursing Theory , Patient-Centered Care/organization & administration , Politics , Psychoanalytic Theory , United KingdomABSTRACT
This article examines the rhetoric and reality of clinical governance in the United Kingdom using the analogy of the New Year pantomime. The authors argue that processes to improve the quality of health care services provision have been in place for many years. Although the terms and language used to describe these processes have, over time, changed, the task remains the same. Clinical governance is the latest in a long list of such changes. The tensions involved in working towards achieving centrally driven targets and performance standards whilst at the same time addressing the huge modernization agenda are explored through managerial and clinical experiences. Whilst the clinical governance approach has undoubtedly achieved improvements, the sustainability of these is questioned. Organisational responses to the current system are explored and a glimpse into the future is given, as the present structures and processes change in 2004. The authors argue that practitioners and managers, who may have survived the current arrangements, might have considerably more difficulty in doing so in the future.
