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Consumer, family/whānau and carer engagement

July 2014

Position statement 62


Summary

Consumers of mental health services and their carers have experience and expertise that clinicians, the RANZCP, mental health service providers and policy makers should draw upon. 

Definition

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) encourages genuine consumer, family/whānau1 and carer and engagement whereby the diverse needs, perspectives, concerns and values are incorporated and help influence all three levels of College business as listed below.

Clinician Level

Psychiatrists are encouraged to work in partnership with consumers, their family/whānau and carers so they have the opportunity to plan, monitor and influence their ongoing treatment in clinical practice. Working in partnership provides consumers access to quality information which assists their decision making and supports an active role for consumers in managing their own health with the support of their carers (Breemhar and Borne, 1991). Research indicates that consumers who are involved in the management of their care experience better health outcomes (Renhard, 1997). Similarly, research indicates that carer involvement at this level provides better health outcomes for consumers.

College Level

The College actively encourages consumer, family/whānau and carer participation within the College structure and decision making processes. Engaging a range of consumers and carers on College Boards and Committees and reference groups enables opportunity for their perspectives to influence quality initiatives which include but are not limited to: policy, planning, and the training of psychiatry registrars and continuing education of College members. The College is continually expanding College policies with influence from Community Members due to their diverse and recognised expertise, unique perspective and lived experience. The College will recognise, by appointments made and support given, the diverse skills and experience that consumers and carers bring through their engagement with the College. The College also believes that Consumer and Carer participation are essential components of continuous quality improvement for the College. To recognise their valuable contribution, the College provides support and remuneration to these community representatives.

Government Level

Standards for mental health services across Australia and New Zealand have been developed as a result of influence from consumer and carer participation in all aspects of the development, planning and implementation of mental health services in all levels of Government. The College acknowledges and supports the role consumers and carers play. Their contribution to policy development and in general, their assistance in setting key priorities to address quality and safety issues in the delivery of mental health services (Lloyd and King, 2003) is essential. The College will utilise its partnerships with the community to maximize influence at all levels of Government.

Evidence

Consumers of mental health services and their carers have a great deal of experience and expertise that clinicians, the College, mental health service providers and policy makers (including all levels of Government) are able to draw upon. Consumer and carer participation is increasingly regarded as a valuable facet of both the Australian and New Zealand health care system (Stewart et al, 2008; Hayman and Fahey, 2007).

At an individual level there is a great deal of evidence to suggest that active consumer participation in decision making in individual care leads to better health outcomes (Gordon, 2005). Literature shows that there is a significant reduction of stress for the carer and/or family of someone with a mental illness if they are involved in the treatment and support of the person they are caring for (Cuijpers, 1999).

Consumers and Carers have made a significant contribution to the College through their participation on College Boards, Committees and project reference groups. This participation has led to the successful completion of many College projects and policy submissions.

At a bi-national level, active consumer and carer engagement and participation leads to more accessible and effective health services (Draper, 1997). Similarly, active involvement of consumers and carers at all levels of the development, implementation and evaluation of health strategies and programs is integral to their success (Gordon, 2005). There is significant evidence that demonstrates that genuine engagement, participation and partnership at all three levels ensures better quality of care, more empowered individuals and better informed entities such as the College and government.

Recommendations

To ensure consumer, family/whānau and carer and engagement at all three levels, it is recommended that, clinicians, the College, mental health services and policy makers including all levels of government:

  • encourage and support the active participation and influence of consumers and carers in the decision making process regarding individual psychiatric treatment and clinical care within the relevant legislative framework
  • actively promote, encourage and support the participation of consumers and carers in the development, planning, influencing, implementation and evaluation of mental health service delivery
  • inform quality improvement of College activities by listening to and utilising the wisdom, views, perspectives and advice of people with lived experience of mental illness and their carers
  • incorporate the expertise of people with lived experience of mental illness in the training of psychiatrists and their ongoing professional development
  • inform consumers and their carers about the structure, processes, functions, roles and responsibilities of the College that will enable their active participation and influence
  • ensure that the selection process for consumers and carers incorporates and recognises the individual for their abilities to influence, collaborate, and apply any other appropriate skills that will enable the relative perspectives to be articulated
  • provide adequate resource for consumers and carers to meaningfully participate.

1 ‘Whānau’ (pronunciation: fa:naᵾ) is a Māori word used to describe an extended family group spanning three to four generations. The whānau continues to form the basic unit of Māori society.

 

Responsible committee: Practice and Partnerships Committee

Breemhar B and Borne H (1991) Effects of education and support for surgical patients. Patient Education and Counselling.

Renhard R (1997) Consumer participation in health care decision making in community based settings and its relationship to health outcomes: final report, quality improvement and community services accreditation. Melbourne, Australia: Victorian Council of Quality Improvement and Community Accreditation.

Taonui R (2012) Tribal organisation – Whānau, Te Ara – the Encyclopedia of New Zealand. Available at: www.teara.govt.nz/en/tribal-organisation/page-4 (accessed 5 August 2014).

Lloyd C and King R (2003) Consumer and carer participation in mental health services. Australasian Psychiatry, 11(2): 180–184.

Stewart S et al. (2008) Set up to fail? Consumer participation in the mental health service system. Australasian Psychiatry, 16(5): 348–353.

Hayman F and Fahey A (2007) Involving carers in mental health service development. Australasian Psychiatry, 15(3): 191–194.

Gordon S (2005) The role of the consumer in the leadership and management of mental health services. Australasian Psychiatry, 13(4): 362–365.

Cuijpers P (1999) The effects of family interventions on relatives’ burden: a meta-analysis. Journal of Mental Health, 8(3): 275–85.

Draper M (1997) Involving consumers in improving hospital care; lessons from Australian hospitals.Canberra, Australia: Commonwealth of Health and Family Services.


Disclaimer: This information is intended to provide general guidance to practitioners, and should not be relied on as a substitute for proper assessment with respect to the merits of each case and the needs of the patient. The RANZCP endeavours to ensure that information is accurate and current at the time of preparation, but takes no responsibility for matters arising from changed circumstances, information or material that may have become subsequently available.