c# pdf to image without ghostscript : Change font pdf fillable form SDK Library project wpf .net azure UWP shari_mcdaid1-part626

EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
2.TheIrishContextforUserInvolvement
2.1Introduction
Mentalhealthserviceuserinvolvementisarelativelynewphenomenoninthe
RepublicofIrelandcomparedtoitscloseneighbours,NorthernIreland,England,
ScotlandandWales. WhileuserinvolvementinEnglandtookoffinthe1980’s,
Ireland’sfirstuser-runadvocacygroupswerenotestablisheduntilthelate
1990’s,mostsignificantlywhentheIrishAdvocacyNetworkreceivedfunding
fromthehealthservicetoprovidepeeradvocacyservicesinanumberofregions.
Scatteredattemptsatinvolvingpeoplewithexperienceinplanningoccurred
duringthistimewithresearchprojects,includingtwonotableParticipatoryAction
Researchprojectsontheviewsofserviceusersaboutservices(WesternHealth
Board2002,2003). TheMentalHealthExpertGroupengagedinuser-led
researchtoobtainuserviewsonservices(DOHC2005).Somementalhealth
serviceuserswereinvitedtoformadvisorycommitteestolocalservices,
participateonregionalplanningcommittees,andparticipateonnationaladvisory
committeestogovernmentagencies.Twopeoplewithexperienceofthemental
healthserviceswereappointedtotheMentalHealthCommissionin2002,and
serviceuserswereinvitedontothementalhealthadvisorycommitteeofthe
NationalDisabilityAuthority. Sotoo,whentheGovernmentannouncedareview
ofmentalhealthpolicyin2003,apersonwithexperienceofmentaldistresswas
appointedtoitsnationalsteeringgroup. Nevertheless,theseattemptsatuser
involvementareveryrecentandhave,untilnow,lackedanycoherentpolicy,
guidelinesorstandards.
Thediscursiveshifttowardsgreateruserinvolvementinplanningisevidencedby
twomajorhealthservicepolicydocuments. In2001,Governmentpublisheda
newstrategyforthehealthservice. QualityandFairness:AHealthSystemfor
Youemphasisedperson-centredcareandaccountability. Itenvisaged
communityinvolvementinplanningthroughconsumerpanelsandregional
forums. Secondly,therecently-publishednewgovernmentpolicyonmental
health:AVisionforChangerecommendsuser(andcarer)involvementatevery
levelofthementalhealthservices(DepartmentofHealthandChildren2006,
p.24)andinitiativestodevelopuser-runservices,educationprogrammesto
enableserviceuserstorepresentthemselvesandothers,andestablishmentofa
NationalServiceUserExecutive(Ibid.,p.26-27). AVisionforChangeis
underpinnedbythe‘recovery’approachtomentalhealthwhichprioritises
people’sparticipationintheirowntreatment.
Thusseveralstrandsofsocialchangehavecometogethertopromotegreater
userinvolvementinmentalhealthservices. Ageneralshifttowardsmore
consumeraccountabilityandgreaterconsumerinvolvementinhealthcareinline
withhealthservicedevelopmentsinotherindustrialisedcountries,thedemands
ofserviceusersthemselvestohaveavoiceinplanning,progressive
professionalswithintheserviceswhopiloteduserinvolvement,theinfluenceof
‘recovery’andadvocacyapproachesfromotherjurisdictions,aswellascriticism
Change font pdf fillable form - C# PDF Form Data fill-in Library: auto fill-in PDF form data in C#.net, ASP.NET, MVC, WinForms, WPF
Online C# Tutorial to Automatically Fill in Field Data to PDF
best pdf form filler; create fillable forms in pdf
Change font pdf fillable form - VB.NET PDF Form Data fill-in library: auto fill-in PDF form data in vb.net, ASP.NET, MVC, WinForms, WPF
VB.NET PDF Form Data fill-in library: auto fill-in PDF form data in vb.net, ASP.NET, MVC, WinForms, WPF
convert pdf to fillable form; converting pdf to fillable form
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
oftheexistingmentalhealthservicesbyNGO’sandtheInspectorofMental
Hospitalsallcombinedtoencourageuserinvolvement.
2.2PowerintheIrishMentalHealthServices
Implementationofuserinvolvementneedstotakeaccountofthehistoryof
psychiatricpowerinIrishsociety. In1961Irelandreachedtheunenviablestate
ofhavingdetainedahigherproportionofitspopulationforpsychiatricillnessthan
anywhereelseintheworld(Walsh1968). Finnane’shistoryoftheasylum
systemshowsthatfromearlyon,medicalpractitionersworkedtoestablishtheir
authoritywithintheasylumsystem(1981,p.40),andby1862,theirauthoritywas
underpinnedbyregulationsinthe1862PrivyCouncilrules(Ibid.,p.47). Sotoo,
thepowerofpsychiatristsbecamefurtherenshrinedinIrishlawintheMental
TreatmentAct1945,whichgaveauthoritytopsychiatristsoverinvoluntary
detentiontosuchanextentthattheycouldonlybetakentocourtundercivil
proceedingsifpermissionwasgrantedbytheHighCourt.
Thispowergivenovertopsychiatristsinthe1860’swasagainunderscoredinthe
Government’smodernmentalhealthpolicyPlanningfortheFuturepublishedin
1984. Thedocumentrecommendedahospital-basedmanagementteam
systemconsistingoftheChiefPsychiatrist,SeniorAdministratorandChief
NursingOfficer(DepartmentofHealth1984,p.124). Atcatchmentarea,
PlanningfortheFuturemadeclearthatthepsychiatricprofessioncontinuedto
holdultimateauthority:
“Thecatchmentareamanagementcommitteeshouldbechairedbya
ClinicalDirector/ResidentMedicalSuperintendent/ChiefPsychiatristwho
willhaveoverallresponsibilityfortheserviceinthecatchmentarea.”
Thispolicyservedtoundermineperspectivesfromotherdisciplinessuchas
socialwork,occupationaltherapyandpsychologythroughoutthelate
20
th
century. Forexample,byputtingtheresponsibilityformanagingcommunity
servicesinthehandsofthepsychiatricprofession,thepolicyunderpinneda
continuedemphasisonhospitalisationandmedicaltreatmentattheexpenseof
communityrehabilitationandalternativetherapies. Withoutauthorityoverthe
primarylocusofcare,theacutehospital,otherdisciplinessuchaspsychology,
occupationaltherapyandsocialworkhadlittleopportunitytoinfluenceclinical
policyorpractice. Therelativelackofpowerofpsychiatricnursesissupported
bytheresultsoftheNurses’&Midwives’UnderstandingandExperiencesof
Empowermentresearch,whichshowedthatnursesandmidwivesinIreland
experienced‘some’butnot‘alot’offormalempowermentintheirjobs(Scott,et
al.2003,p.39)
ArecentdiscussionpaperbytheMentalHealthCommissionconfirmsthatthis
hierarchicalorganisationofthementalhealthservicescontinuestoday(MHC
2005). AVisionforChangecontinuestoassignbothclinicalresponsibilityand
‘vision’topsychiatrists. Itthuscontinuestosupportpsychiatriccontroloflocal
mentalhealthservices. However,atnationallevel,psychiatricprofessionalsare
intheminorityonthenewMentalHealthServiceDirectorate,andthenewCare
C# PDF Field Edit Library: insert, delete, update pdf form field
PDF form creator supports to create fillable PDF form in C# Able to add text field to specified PDF file position in C# Support to change font size in PDF form.
c# fill out pdf form; create fillable pdf form
C# PDF Text Box Edit Library: add, delete, update PDF text box in
framework. Able to create a fillable and editable text box to PDF document in C#.NET class. Support to change font color in PDF text box.
convert word to pdf fillable form; convert pdf fillable form to html
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
GroupManagerforMentalHealthisnotrequiredtobeapsychiatrist.Thisopens
upthepossibilityfornon-psychiatricleadershipatthehighestlevel. Thepotential
forinterruptingcurrentpowerrelationsisaidedbythepresenceofaserviceuser
onboththeAreaManagementTeamandtheNationalMentalHealthService
Directorate. However,itisnotself-evidentthatasingleserviceuserona
committeecanhaveanysignificantinfluenceoverdecision-making. Thedanger
of‘tokenism’isdemonstratedbyearlyreportsonuserinvolvementintheUK
(Croft&Beresford1995,p.64),andbywhatisdocumentedbelowinthe
experiencesofserviceusersinIreland.
VB.NET Create PDF from Word Library to convert docx, doc to PDF in
Change Word hyperlink to PDF hyperlink and bookmark. VB.NET Demo Code for Converting Word to PDF. Add necessary references: RasterEdge.Imaging.Font.dll.
.net fill pdf form; convert word document to pdf fillable form
VB.NET Create PDF from Excel Library to convert xlsx, xls to PDF
Change Excel hyperlink to PDF hyperlink and bookmark. VB.NET Demo Code for Converting Excel to PDF. Add necessary references: RasterEdge.Imaging.Font.dll.
pdf fill form; change font size in fillable pdf form
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
3. EqualandInclusiveUserInvolvement:AnEqualityof
ConditionFramework
3.1TheSignificanceofEmpowermentforUserInvolvement
Issuesofempowermentareattheheartofequalinvolvementforpeoplewith
experienceofthementalhealthservices(seeBowl&Ross1994,Croft&
Beresford1995,Hickey&Kipping1998,Linhorst&Eckert2003,theScottish
DevelopmentCentreforMentalHealth2003,Wallcraft,etal.2003,Chamberlin
2005andHodge2005). WhileAVisionforChangeusesthetermempowerment
onlytwiceinits284pages,thelinkbetweenuserinvolvementandempowerment
ismadeclearintheintroductiontoitschapteronpartnershipincare,whenit
statesthatinvolvingserviceusersandcarersasactivepartnersintheplanning
anddeliveryofmentalhealthservicesisa“necessarysteptowardsmoreequal
andfaircommunicationbetweenallmentalhealthparticipants.”(DOHC2006,
p.24). Userinvolvementoftenreferstoempowermentintermsofindividual
consumer’spowerand promotinggreaterresponsivenessofservicesto
individualuserneeds,suchasinsectionsofthepolicydocumentQualityand
Fairness:AHealthSystemforYouHoweverthediscourseinAVisionfor
Changerestsonamoredemocratically-framedconceptionofinvolvement. It
emphasisesthatinvolvementshouldgobeyondconsultationandshouldconsist
ofparticipationindecision-makingateverylevelofthementalhealthservices
(OpCit.,p.25).
Serviceuserdefinitionsofempowermentshowthatforthem,empowermentis
indivisiblylinkedtoincreasedauthorityoverdecision-making. Chamberlin’s
definitionderivedfromserviceuserresearchincludeselementsofpowersuchas
havingchoicesandhavingdecision-makingpower(Chamberlin,etal.1997).
BeresfordandCroft’sdefinitionspecifiesempowermentas,“[m]akingitpossible
forpeopletoexercisepowerandhavemorecontrolovertheirlives..Italsomeans
beingabletosharepowerorexercisepoweroversomeoneelse,aswellasthem
exercisingitoveryou.”(Beresford&Croft1993). Thisdefinitionisalsosupported
byPeterCampbell(Campbell1994). Somecriticismhasbeenlevelledat
empowermenttheoryforover-emphasisingindividualisticqualitiesof
empowermentsuchasincreasedself-confidenceandcompetencydevelopment
attheexpenseofstructuralfactorsforempowerment(Fondacaro&Weinberg
2002).
3.2AnalysingUserInvolvementusinganEqualityofCondition
Framework
An‘EqualityofCondition’frameworkcanhelptoexplainpowerinequalitythrough
asetofrelateddimensionsofinequality. Intheirworkonegalitariantheory,
Baker,etal.(2004)havepositedfivedimensionsofinequality:power,resources,
respect&recognition,working&learning,andlove,careandsolidarity. ‘Equality
ofCondition’refersto“enablingandempoweringpeopletoexercisewhatmight
C# Create PDF from Word Library to convert docx, doc to PDF in C#.
Change Word hyperlink to PDF hyperlink and bookmark. C#.NET Sample Code: Convert Word to PDF in C#.NET Project. RasterEdge.Imaging.Font.dll.
adding signature to pdf form; convert excel to fillable pdf form
C# Create PDF from OpenOffice to convert odt, odp files to PDF in
An advanced .NET control to change ODT, ODS, ODP forms to fillable C#.NET Project DLLs: Conversion from OpenOffice to PDF in C#.NET. RasterEdge.Imaging.Font.dll.
add attachment to pdf form; convert pdf to form fillable
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
becalledrealchoicesamongrealoptions,”and“roughlyequalenablingofeach
persontoinfluencethedecisionsthataffecttheirlives.”(p.34).
Muchoftheresearchonuserinvolvementhasindicatedarangeofserviceuser
needstoenableeffectiveparticipation. However,typicallythesearelisted
withoutanyrelatedanalysisoftheinequalitiespeoplewithadiagnosisofmental
illnessfacerelativetomentalhealthprofessionals. Thedangeristhatsuchlists
ofneedswillbeseenasarbitraryandunrelated,andthereforewillbeaddressed
inanadhocway. Byanalysingtheevidencewithinan‘equalityofcondition’
framework,Ihopetodemonstratethatdisadvantagesmustbeaddressedinaco-
ordinatedwayacrossallcategoriesofinequalityinordertoenableempowerment
andestablishmoreequalrelationshipsinplanningcommittees.
3.3InequalityofRespectandRecognition
Forpeoplewithadiagnosisofmentalillness,theirinequalityofpowerisprimarily
determinedbythepervasiveprejudice,fearand‘stigma’againstmentalillness
whichpersistsinWesternsocieties.Thispredominantlackofrespectand
recognitioncanleadtoalackofconfidenceinsocialsituations,lackof
willingnesstoidentifyasaserviceuser(desiretodistanceoneselffromthe
mentalhealthservices),andlackofwillingnesstospeakoutpublicly. Formental
healthserviceusers,pastorpresent,theculturalvaluesattachedtotheir
experienceareaconstantaccompanimenttotheirexperiencesofsocial
participation. Inanymixedsocialsituationwheretheyidentifythemselvesasa
mentalhealthserviceuser,theirparticipationcannotbeinnocentofthegeneral
perceptionthattheyare‘other’. Theliteratureonuserinvolvementatteststothe
negativeimpactthislackofrespecthasonparticipation. PeckandBarker(1997)
notedhowserviceusers’viewsarenotvalued. Barnes&Wistow(1994)found
thatthevalidityofserviceusers’statementswasunderminedwithclaimsoftheir
‘lackofinsight’,whileasrecentlyas2003,Summersfoundthatamongst
scepticalpsychiatrists,users’viewswereconsideredunnecessaryandirrelevant
totheprocessofservicedevelopment.Onabroaderview,Barnes&Shardlow
(1997)discussedhowstigmanegativelyimpactsonsocialinclusionandactive
citizenship.
3.4InequalityofEconomicResources
Inequalityintermsofresourcesincludeseconomicinequality,e.g.differencesin
incomeandearningspower. Disadvantageintermsofeconomicresourcesis
well-evidenced. IntheUK,unemploymentforpeoplewithlongtermmental
healthproblemshasbeenestimatedat79%(DisabilityRightsCommission
(2003)). InIreland,arecentQuarterlyNationalHouseholdSurveyshowed86%
ofpeoplewith“mental,nervousoremotional”healthdifficultieswereeither
unemployedoreconomicallyinactive(CSO2004). Withsuchahighrateof
unemployment,itisself-evidentthatpeoplediagnosedwithamentalillnessare
VB.NET Create PDF from PowerPoint Library to convert pptx, ppt to
Files; Split PDF Document; Remove Password from PDF; Change PDF Permission Settings. VB.NET Demo Code for Converting PowerPoint to PDF. RasterEdge.Imaging.Font.dll
create a fillable pdf form online; convert word form to pdf with fillable
C# Create PDF from PowerPoint Library to convert pptx, ppt to PDF
Convert multiple pages PowerPoint to fillable and editable PDF documents. C#.NET Demo Code: Convert PowerPoint to PDF in C#.NET RasterEdge.Imaging.Font.dll.
create a pdf with fields to fill in; add signature field to pdf
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
athighriskofpoverty. Economicdisadvantagealsoimpactsonserviceuser
involvement. Theliteratureshowsthatusersrequireeconomicresourcesin
ordertobeabletoparticipate(Linhorst&Eckert2003,ScottishDevelopment
Centre2003,Wallcraft,etal.2003,Stevenson,etal.2005).
3.5InequalityofCulturalResources
Inadditiontoeconomicresources,participantsoncommitteesrequirearangeof
culturalresourcesinordertoparticipate. Theculturalresourceswhich
professionalsareabletodrawuponbeginwiththeirculturalcompetencygained
fromthird-leveleducation. Professionalsalsoenterthecommitteemeeting
situationwell-versedinaninstitutionalmanageriallanguage,including
abbreviationsandtermsrepresentingelementsinthementalhealthsystem.
Theyarrivewithanunderstandingofthehierarchyofdecision-makingauthority
withinthesystem. Andingeneraltheyhaveaknowledgeofthepolicyhistory,
i.e.thecontextofhistoricaldocumentsandexistingpolicieswhichframethe
contextofcurrentpolicymaking. Ingeneral,professionalshaveanunderstanding
oftheexplicitandhidden‘rulesofthegame’ofcommittees. Theyknowhowto
getissuesontotheagenda,thestatuspositionsofthemembersofthecommittee
andtheirsocialrelationshipsoutsidethecommitteesituation. Allofthiscreatesa
‘culturalcompetency’advantageforprofessionalsrelativetoserviceuserson
committees.
Serviceusers’culturaldisadvantageisacommonthemeintheliteratureonuser
involvement. Theliteraturehashighlightedtheneedforaccessibleinformation
andlanguage(Beresford&Croft1993,Linhorst&Eckert2003,Scottish
DevelopmentCentreforMentalHealth2003, Stevenson,etal.2005,Wallcraft,
etal.2005,Chamberlin2005). Church(1996)showedhowserviceusers’
attemptstore-definetherulesofcommitteesweredeemed‘badmanners’.
Recently,MarianBarneshasarguedthatthe‘rulesofengagement’for
citizenshipparticipationinprofessional/bureaucraticgovernanceare
fundamentallybiasedagainstpeoplewithmentalhealthdifficultiesbecausethey
arebasedonnarrowassumptionsofcompetence(Barnes2002).
3.6InequalityofPhysicalandMentalResources
Inadditiontoeconomicandculturalresources,peoplebeingtreatedformental
distressalsooftenhavelessphysicalandmentalresourceswithwhichtoengage
inthecommitteesituation. Barnes&Wistow(1994)emphasisedhowthe
symptomsandsideeffectsofmentaldistresscanmakeitdifficulttospeak.
Participantsinthisresearchprojectraisedissuesofpoorphysicalhealthinterms
ofenergyandstamina. Theyparticularlyraiseddifficultieswithpoor
concentrationmakingitdifficulttomaintainparticipationinlongmeetingsorread
longpolicydocuments. Peoplewithexperienceofmentaldistressalsohavea
particularneedtominimisestress. Stressisknowntobeassociatedwithhearing
voices(Boyle2006)andanumberofstudiesshowthatstressreductionis
associatedwithimprovedrecoveryandpreventionofrelapse(Mueser,etal.
C# Create PDF from Excel Library to convert xlsx, xls to PDF in C#
Create fillable and editable PDF documents from Excel in both .NET WinForms C# Demo Code: Convert Excel to PDF in Visual C# .NET RasterEdge.Imaging.Font.dll.
create a fillable pdf form from a pdf; attach image to pdf form
C# Create PDF Library SDK to convert PDF from other file formats
Create fillable PDF document with fields. Load PDF from existing documents and image in SQL server. RasterEdge.Imaging.Font.dll. RasterEdge.XDoc.PDF.dll.
change pdf to fillable form; convert word document to fillable pdf form
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
2002).Thisdoesnotmeanthatpeoplewithexperienceofmentaldistressare
anylessabletoengageincollectiveadvocacy,butitdoesmeanthatlikeother
peoplewithdisabilities,theyrequiresomeaccommodationssuchasbreaks
duringmeetingsinordertofullyparticipate.
3.7InequalityofLove,CareandSolidarity
Finally,oneoftheconsequencesofadiagnosisofmentalillnessisareductionin
existingsocialnetworksandanincreaseinsocialisolation(Wright,etal.2000,
Goldberg,etal.2003). Professionalsarriveatthecommitteesituationwitha
rangeofsocialsupports,including,commonly,intimaterelationships,collegial
relationshipsandmembershipinprofessionalorganisations. Thisnetworkof
supportsprovidesprofessionalswithabasefromwhichtoorganisetheir
collectiveadvocacyandasetofemotionalsupportsfortheirparticipation.
Incontrast,peoplewithadiagnosisofmentalillnessexperiencesocialrejection
(Wright,etal.2000). Theyexperiencestigmaduringinterpersonalinteraction
(Angermeyer2004). Theymayalsolackaccesstorelationshipsofwarmthand
intimacy(Cook2000). Theyarelikelytohavelosttheirnon-mentalhealth-related
socialnetworkuponreceivingadiagnosis.Thusmentalhealthserviceusersare
commonlyatadisadvantageintermsofthesocialresourceswhichmany
professionalsmayhave. Whilementalhealthserviceusersmaybepoorerin
confidenceandsocialsupports,andaresociallyexcluded,theyalsohaveless
accesstotheemotionalsupportwhichwouldmakesuchasituationbearable.
3.8InequalityinWorking&Learning
Finally,peoplewithadiagnosisofmentalillnesstypicallyhavelessopportunityto
developcommittee-relevantskills. Symptomsofmentaldistressnormallyoccur
duringprimeeducationyearsfromthelateteenstoearlytwenties. Peoplewith
mentaldisabilityarelesslikelytohavecompletedthird-leveleducation.
Theconsequencesofthisarethatingeneraltheyhavelowerlevelsofanalytical
skills,computerskills,writingskillsandpresentationskillsthanprofessionals.
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
Theconstellationofinequalitiesfacedbypeoplewithadiagnosisofmental
illnessareillustratedinthediagrambelow:
DimensionofInequality
Experienced byMental
HealthServiceUsers
Resources–Economic
LackofEconomicResources
Resources–Culturalcapital
Lackofcontext-specific
knowledges
Lessformaleducation
Resources–Embodied
capacity
Lessphysicalandmental
stamina
Respect/Recognition
Stigmaandprejudiceagainst
peoplewithahistoryof
mentalillness
Lessself-confidence
Love,CareandSolidarity
Socialisolationleadstoless
emotionalsupport
Working&learning(self-
actualisation)
Lackofopportunitiesto
developskills
Theseinequalitiescombinetomilitateagainstequalparticipationwith
professionalsinthecommitteesituation. Itisthisfullrangeofinequalitieswhich
mustbeaddressedifserviceusersaretobeempoweredtoparticipateequally
withprofessionalsinmentalhealthservicecommittees.
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
4.Methodology
4.1Overview
Theresearchwasconductedusingparticipatoryactionresearchmethodology.
Asaqualitativemethodologysimilartoethnography,itdoesnotclaimto
representtheviewsofallserviceusers. However,itdoesauthenticallyevidence
arangeofexperiencesofuserinvolvement. Italsocoversviewsfromdifferent
regions,differentagesandbothmenandwomen,aswellastheviewsofpeople
withdifferentlevelsofeducation. Theresearchwascarriedoutinfivephases:
pilotinterviews,introductoryworkshop,pilottrainingprogramme(theaction
element),analysis,andtriangulation.
Pilotinterviewswithfiveserviceuserswerecarriedoutinordertodevelopthe
researchquestion. Twooftheseserviceuserswereknowntothelead
researcherthroughherworkatSchizophreniaIrelandandthreeotherswere
contactedviasnowballing. Allofthepilotintervieweeshadexperienceofbeing
onamentalhealthserviceadvisorycommittee. Severaloftheinterviewees
expressedtheneedfortrainingandsupportforpeoplewhoweresittingon
advisorycommittees. Itwasdecidedtoconductanintroductorytraining
workshop. Theworkshopwasorganisedbyacommitteeconsistingoftwo
serviceusers,theleadresearcherandoneRegionalDevelopmentOfficerat
SchizophreniaIreland.
Thepoolofparticipantsfortheintroductoryworkshopwasdevelopedlargely
throughword-of-mouthwithinSchizophreniaIreland,bycontactingtheRegional
DevelopmentOfficersacrossthecountryandaskingthemtosuggest
participants. Intotal,14participantsfromacrossIrelandparticipatedinthe
introductoryworkshop. Theworkshopwasfacilitatedbyaserviceuserwhois
alsoatrainedfacilitator. TheworkshopconsistedofapresentationbyaU.K.
expert,traininganddiscussiononuserinvolvementandpresentationsoncurrent
Irishlegislation.Intheworkshopevaluation,participantsidentifiedtheneedfor
furtherskillstraining.
Thedevelopmentofapilottrainingprogrammewasthenpursuedthrough
SchizophreniaIreland’sserviceuserConsultativeGroup. Membersofthe
ConsultativeGroupandinterestedparticipantsfromtheintroductoryworkshop
becamethecorepoolofparticipantsfortheresearch. Inadvanceofthetraining,
one-to-onesemi-structuredinterviewswerecarriedoutbytheresearcherwith
trainingparticipants.Thefocusoftheinterviewswastoidentifythebarriersto
userinvolvementinIreland. Theinterviewswereanalysedwitha‘grounded
theory’approachusingMaxQDAanalysissoftware. Adraftinterviewanalysis
waspresentedtotheparticipantgroupforvalidationandtheircomments
incorporatedintothefinalanalysis. Thedatafromtheinterviews,introductory
workshopdiscussionandtrainingprogrammesessionshasbeentriangulated
with5interviewswithleadersintheserviceusermovementinIreland. Eachof
theleaderswasalsogiventhedraftanalysisforcomment.
EqualandInclusiveUserInvolvementintheMentalHealthServicesinIreland
Page62
4.2ProfileoftheParticipants
Atotalof16serviceusersand5leaderswereinterviewed,ofwhom13
participatedinthetrainingprogramme. Themajorityofparticipantshada
diagnosisofschizophreniaorarelatedpsychoticdisorder,andallofthe
participantshadlong-termengagementwiththementalhealthservices. While
thetotalnumberofparticipantsandleaderswassmall,theycoveredawide
rangeofexperiences. Participantsrangedinagefrom19to60yearsold,while
leaderswereaged40to59.10menand6womenwereinvolvedinthe
participantgroup,while3menand2womenwereintheleadergroup. Mostof
theparticipantswerefromtheDublinarea,howevertherewerealsoparticipants
fromGalway,KilkennyandLimerick. Boththeparticipantgroupandtheleader
grouphadrelativelyhighlevelsofeducation. Inthetrainingparticipantgroup
fourpeoplehadBachelors’leveleducation,whileamongsttheleadergroup,four
outoffivehadBachelors’leveleducation.Theparticipantgroupconsistedof
peoplewhoareengagedwiththesupportservicesofSchizophreniaIreland,a
nationalvoluntaryorganisationforcarersandpeoplewithschizophreniaand
relatedillnesses.
4.3ReflexiveNote
Theresearchprocesswasprofoundlyimpactedbymypre-existinglong-term
relationshipwithanumberoftheparticipants. Threeoftheparticipantshadbeen
employeesofSchizophreniaIrelandandworkedundermysupervisionwhileI
wasemployedasAdministrationManager. Otherparticipantsknewmecasually
frommyhavingbeenanemployeeatSIwhiletheywereactivemembers. With
otherparticipants,ourrelationshipdevelopedoutoftheprocessofplanningthe
initialworkshop,anddeepenedthroughthecourseofthepilottraining
programme. IlefttheemploymentofSchizophreniaIrelandearlyoninthe
researchandthiscertainlychangedmyrelationshipwiththesingleparticipant
whohad,atthattime,stillbeenundermysupervision. Ibelievethatthesegood
relationshipsallowedparticipantstosharetheirviewsmorefreelythantheymight
haveotherwise.
Theresearchwasalsoinfluencedbymyownexperienceofmentalhealth
difficulties. Whileneverhavingbeenhospitalisedformentaldistress,Ihavebeen
treatedbothpsychologicallyandpharmacologicallyforananxietydisorderand
thisallowedmesomeempathywiththebodilyexperienceofmentaldistress.
SchizophreniaIrelandunderwrotethecostsofthetrainingprogrammeand
providedvenuesandpersonnelsupportformeetingsthroughouttheproject.
Aspartoftheresearchagreement,thetextofthisarticlehasbeensubmittedto
theDirectorinadvanceofpublication.
Documents you may be interested
Documents you may be interested