Arts & Social Sciences
Te Kura Kete Aronui

Abstract

Read, Jacob. (2002) Emancipation songs: consumers' views on individual treatment participation in mental health care

Recent New Zealand mental health policies that focus on individual consumers participating in treatment decisions aim to move traditional professional relationships with an emphasis on care giving toward new roles that promote partnership, strengths and working together with consumers to build capabilities. Evidence from the literature indicates that participating in making decisions is a key element in living well in the absence or presence of mental health symptoms. This research explored consumers' views on what individual treatment participation really means within the context of using a in-patent mental health care located in a provincial New Zealand city and whether consumers believe participation is critical to their experience of recovery from mental illness. Additionally this study examined how individual service users’ capacity to participate in making treatment decisions is facilitated or impeded by legislative, policy, organisational and individual factors.

Findings were gathered via an analysis of mental health policy and legislation and semi- structured interviews with seven local consumers and two consumer advocates. Participants were all involved with the same in-patient mental health service within the past twelve months. Five consumers had used the service voluntarily and the other two had been placed in the service under compulsory treatment orders.

Consumers were asked to describe their experiences before, during and after in-patient admission. Consumers and advocates were also asked a series of closed questions based on literature about treatment participation. An inductive approach was employed to analyse the findings.

The findings from this study are consistent with literature on individual treatment participation. My analysis of New Zealand Mental Health legislation and policy suggests that aspects of the Mental Health (Compulsory Assessment and Treatment) Amendments Act 1999 are among the factors impeding implementation of the more participatory approaches set out in recent Mental Health policy guidelines.

Treatment participation was found to be a shared task because it involves both consumers and mental health workers performing different sub-tasks to achieve a situation where participatory decision making is possible. These participatory decision-making processes are described differently by individual consumers in terms of consultation, partnership or self-help.

Consumers want to participate in making decisions about their mental health treatment. Empowerment, trust, respect and recovery were the major themes to emerge as reasons why consumers wanted to participate.

The findings indicated that treatment participation is impeded due to a combination of legislative, organisational and individual factors. Breaches of rights, poor discharge procedures, few alternatives to medical treatments and lack of information from staff about mental health conditions preventing treatment participation. Future research could offer valuable insights into how in-patient services may promote treatment participation.