Involving Service Users in Mental Health Policy Making

There has been increasing support for the engagement of people who use mental services in the process of policy improvement. It would seem to make sense that those most directly affected by policy responses should have their views represented. This brings in to question the alternate forms of ‘evidence’ that can be used as part of evidence-based practice.

A recent study, conducted in Australia, has analysed interviews with individuals involved in drug policy discussions.

The aim of the study was to see how the idea of “consumer” is considered in relation to the discussion around the development of ‘evidence-based policy’, as well as question how power may be seen as centred through evidence-based practice, which may be considered conservative in the way it values forms of knowledge.

Participants included policymakers, advocates, non-governmental organisation representatives, consumer representatives, researchers and clinicians.

The authors present their findings in relation to two overarching ideas: Enacting difference, constituting “consumers”, and Difference and resistance.

Enacting difference, constituting “consumers”:

• The drug policy ‘sector’ is viewed as a disjointed collection of different people with different perspectives and distinct interests in the policy process.
• It was almost universally assumed that ‘consumers’ would be less powerful than others engaged in the policy process
• It was clear the development of evidence-based policy privileges the ‘objective’ and ‘rational’ knowledge of clinicians and researchers

Difference and resistance:

• Considered, rational argument and objectivity instead of subjectivity  fit more easily  with  ‘evidence-based policy’
• Lived experience is devalued
• There was a lack of alignment between understanding through lived experience and knowledge through scientific or ‘evidence-based’ definition.

Overall, although there is a move towards service user participation in developing policy, there is clear tension between the concept of ‘evidence base’ and how the process can be made to be inclusive.