I have had many conversations and read great articles about engagement and partnership in mental health treatment. My post about #WhyWeDontEngage and subsequent response have been the most viewed on this blog. An interesting phenomenon happened, the most re-blogs, shares, and conversations on twitter seemed to be from the service users / customers / and advocates themselves. There were some professionals that responded as well. I know there are wonderful professionals out there. I am not questioning that. Simply looking to our customers to help us figure out how to better manage “the system”. Based on #WhyWeDontEngage, there seems to be a disconnect between people who utilize mental health services and the people that provide them.
This needs to change and it seems like mental health and healthcare are the only industries where we don’t like to talk about “customer service”. We need to start with the individual and work our way out. It is important to bridge this gap and this is how I think we can make this happen.
Language has Power – We first have to be mindful of the power of language. I got called out by a lot of people about using “patient” or “client”. These are words we use on a daily basis but the power differential and paternalistic nature of this calls this in to question. What do we say instead? “Customer” or “Service User” seemed to the top one. This not a new debate but it made me reflect on how we “do business” as providers.
The question about what to call this this relationship highlights the need for it to BE a relationship. There are many “patient-centered” or “client centered” approaches. The mere fact we need to use these labels points out there is a barrier to this partnership. As a consumer of our product, we should always listen to them and help them guide what they want in the service. If we view persons as consumers it negates the need to have a “patient-centered” practice. Being the consumer makes it implicit that they are part of it.
Finding Peer Support Organizations– bringing this to a more community level (mezzo / Macro level) there are “Peer Run” organization in your community. The big one in the United States in NAMI and also Mind in the UK. There are a lot of grassroots organizations and as providers we should be seeking them out. I encourage you to look these up, find out what supports are available, and refer customers to them. If they are already involved this kind of organization, get a release of information to coordinate care.
Reach out to Peer Support Organizations. As professionals we could be reaching out to peer run organizations and develop potential partnerships. In the last several years I have seen two very successful partnerships between peer run organizations and mental health facilities. The first was when working on an inpatient unit. There were “Peer Bridger’s” from one organization that assisted customers with discharge planning (see how using customer changes everything 😉 ). This was an effective program that often reduced re-admission and made people feel like they had a partnership. Peer Bridger’s also did groups.
In two separate organizations I have seen outpatient clinics use peer organizations in the same manner. They have done groups and provided individual support. These were also effective as well. There is growing evidence base that peer services work on many levels.
Policy and Process to Support Collaboration– I like the term “system of care”. Again one of these bits of language we need to think about. What policies and procedures can we put in place to demystify the process between mental health providers and customers? It is easy to blame insurance companies and productivity demands as scapegoats for providing poor care. It is a lot harder to look at your organization and your process to improve “customer service”. Does your “system of care” truly embrace the idea as people as customers or active participants?
Larger policy questions need to be answered. Should there be more grants to encourage customer and provider collaboration. Should insurance companies reimburse for peer supports?
Looking to customers to improve the mental health system just makes sense. Let’s leverage the community to make our “system of care” even stronger. In the spirit of inclusion I would enjoy continued feedback from everyone. I would especially enjoy hearing from professionals about how to improve the gap between us and our customer’s. If you are on twitter you can also look at and contribute to using #WhyWeShouldInclude.