1. Northern Ireland NHS Confed national conference April 16th 2015 Michael Ryan Director Advancing Recovery Ireland

2. Service user partnership working together A new way
Michael Ryan, project lead Advancing Recovery Ireland
Special Needs Teacher, Social Care Worker
Farmer ,Computer salesman
Spouse, Father, Sibling
Community council, Football coach
Mental health Service user

3. Service user partnership working together A new way
Lived experience
Debilitating force
Hospitalization
Self harm
Homelessness
Fear
Confusion
Despair

4. Service user partnership working together A new way
Personal Recovery
Social Integration
Independent Living
Meaningful Roles/ Employment
Full Citizenship
A regular Joe Bloggs!

5. Service user partnership working together A new way
Someone to love
Somewhere to live
Something to do

6. Service user partnership working together A new way
‘Recovery is a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles.
It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness’. (Anthony, 2003)

7. Service user partnership working together A new way
PERSONAL RECOVERY: 3 essential features (Repper & Perkins 2000)
1)HOPE – believing that one can still pursue one’s own hopes and dreams, even with the continuing presence of illness. Not ‘settling for less’, i.e. the reduced expectations of others
2) ‘AGENCY’ – (re)establishing a sense of control over one’s life and one’s illness. Finding personal meaning – an identity which incorporates illness, while retaining a positive sense of self
3) OPPORTUNITY – to build a ‘life beyond illness’. Using personal strengths and resources, non-mental health agencies, friends and informal supports to achieve real integration in the community

8. Service user partnership working together A new way
Why partner with Patients
Life style illnesses- By 2020, it is predicted that Non communicable diseases, cancer, diabetes, chronic pulmonary and mental health problems will be causing seven out of every ten deaths in developing countries. – (International Journal for Equity in Health Research January 2005)
Current model unsustainable –
Medically, Economically, Politically, socially, Ethically

9. Service user partnership working together A new way
Why partner with Patients
Service users want partnership-
‘people want to play a part in making decisions about their own health care and that people living with a long-term illness develop an ‘expertise and wisdom’ about the condition ‘(Brophy 2006)
The increased interest in service user involvement is linked to the recognition that many of the health problems faced by the community are complex, and go beyond the capacity or jurisdiction of any single organisation to change or control (Lasker and Weiss 2003)

10. Service user partnership working together A new way
Benefits of Partnership
Better patient experience – increased satisfaction
Increased sense of dignity & self worth
Validation of patient experience
Improved communication
Improved problem solving
Improved service planning
Better recovery outcomes
Economic benefits
Culture change
(Brophy 2006, Nielsen et al 2004, Gregory 2007)

11. Service user partnership working together A new way
Policy on Partnership
WHO -patients can play an important role in understanding the causes of illness, protecting their health and taking appropriate action, choosing appropriate treatments for acute episodes of ill health, and managing chronic illness. These roles must be recognized and supported. - Where are the patients in decision-making about their own care? (2008)
NHS- Ensure that every person with a long-term condition or disability has a personalised care plan supporting them to develop the knowledge, skills and confidence to manage their own health. TRANSFORMING PARTICIPATION IN HEALTH AND CARE 2013

12. Service user partnership working together A new way
Policy on Partnership
HSE- The service user should be central to their own care and to the design and delivery of health and personal social services. This will result in more appropriate services of a higher quality with increased service user compliance and satisfaction. National Strategy for Service User Involvement in the Irish Health Service
HSE mental health-“Involvement of service users and their carers should be a feature of every aspect of service development and delivery”. (vision for change 2006)

13. Service user partnership working together A new way
A practical application
Tokenism!- it is possible to be engaged in numerous involvement activities without really involving people particularly if professionals continue to drive the agenda and make decisions about services and treatments without taking service users views into account . (Coney 2004)
Human level-‘the most significant forms of involvement are those that become part of the day-to-day practice of health care delivery and planning, whether at the level of the individual encounter or at a more collective level, yet these are often the least visible. (Ridley and Jones 2002)

14. Service user partnership working together A new way
Partnership in Practice
HSE structures -National advocacy unit- Director of Advocacy
Irish Advocacy network ( Independent mental health voice)
National directorate for mental health
National head of service user, family & carer engagement – 2014
9 Regional heads of service user, family & carer engagement- 2015

15. Service user partnership working together A new way
Partnership in Practice
Engagement- listening meetings, surveys, forums, focus groups , reference groups, reps on committees, consumer panels
Professional roles - Peer support working ,Hse 2015 NI 2018
Su & family using their own lived experience to empower others to recover.

16. Service user partnership working together A new way
Partnership in Practice
Recovery education (Recovery Colleges 1 Mayo 1 NI, 32 UK , world wide)
Recognises the equal expertise of Su & other stakeholders as co creators of recovery.
Su assume new identity as students
Everything is co produced by equals (Su, Family, professional
Community wellness Colleges (not just mental health)

17. Service user partnership working together A new way
Multiple Partnerships
Service User
Family & Supporters
Clinicians
Voluntary Sector
-Education
Housing
Employment support
Wider community

18. Service user partnership working together A new way
What do we bring to our roles?
Professional experience
Lived experience
Skills & talents
Human experience

19. Service user partnership working together A new way
Expert Patient
Lived experience of mental health issue
Empathy and understanding
Understanding of condition -triggers
Experience of Personal Recovery
Holder of hope
Professional Peer support worker

20. Service user partnership working together A new way
Family Member/Supporter
Experience of living with someone with mental health issue
Understanding of condition –triggers
Understanding of personal recovery
Holder of hope
Collaborative working
Professional family advocate

21. Service user partnership working together A new way
Service provider/ Clinician
Clinical & professional experience
Lived experience
Human experience
Holder of hope
Clinical recovery- reframing the treatment…the issue is what role treatment plays in recovery (Davidson 2006)

22. Service user partnership working together A new way
NHS – Education for Scotland
Service user partnership working together A new way
Rehabilitation is a therapeutic framework for seeking recovery with people who have complex and disabling mental health problems, mostly enduring psychosis (Roberts, 2011)
Facilitators’ Toolkit

23. Service user partnership working together A new way

24. Cubism Coproduction A Partnership and Collaborative working approach
Recognising , respecting & utilising mutual expertise & perspective
Moving to a new place together……
RECOVERY

25. Service user partnership working together A new way
Organisational change ImROC methodology
Senior management commitment - national policy – A vision for change
Recovery principals – different types of expertise
Real collaborative working between all stakeholders
Audit services & identify key areas to address

26. Service user partnership working together A new way
ImROC 10 Key Organisational Challenges
Changing the nature of day to day interactions and the quality of experience
Delivering comprehensive user-led / family member / carer training and information programmes
Establishing a Recovery education unit to drive the programmes forward
Ensuring organisational commitment, creating the ‘culture’. The importance of leadership
Increasing ‘personalisation’ and choice
Changing the way we approach risk assessment and management.
Redefining service user / family member / carer involvement.
Transforming the workforce.
Supporting staff in their recovery journey
Increasing opportunities for building a life ‘beyond illness’

27. Service user partnership working together A new way
Challenges to Partnership
Power Imbalance
Remuneration issues
Structural issues
Language & bureaucracy issues
Constituency capacity deficits
Cultural challenges

28. Service user partnership working together A new way
Thank God for the foolishness to think that you can make a difference- Benedictine blessing
Patient Partnership is possible is possible…

29. Service user partnership working together A new way
Thank You
Michael Ryan