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Basiletti and Townsend’s Paper COTEC 2012

Basiletti and Townsend’s (2012) paper is of interest because it focuses on service user involvement in mental health services. Although it can be described as service user and care involvement in mental health services it is really much broader. Basiletti and Townsend (2012) delve into group decision-making, which is not always obvious in other studies of service user and carer involvement. My experience is, and this may reflect the scope of my reading, that a lot of work on service user and carer involvement focuses on the mechanics of bringing people together rather than how they actually work together. Whilst this paper is based on a practice setting its lessons could also be translated into research teams that are involved in making group decisions about research projects.

This is a well written, readable paper. It is no accident that paper presentation given at the COTEC conference was very engaging; Basiletti is a skilled communicator. The authors have used reporting techniques that enable understanding of the data but which also preserve the anonymity and confidentiality of the participants. This was vitally important because Basiletti and Townsend (2012) were reporting data from a small group of people who belong to a small community. As well as being written up sensitively the research was conducted with sensitivity. For example a research assistant secured informed consent because the participants were known to the first author. In reporting the data the authors also explore aspects that may relate to their bias or assumptions.

The study is a good example of a qualitative single case study. I was intrigued that, whilst all of the consumer/advocates agreed to participate, only two of the five service providers did. Basiletti and Townsend (2012) acknowledge this as a limitation in their findings. Obviously I have no idea what the reasoning was, of those who chose not to participate, but it made me wonder whether the service was only providing lip service to the idea of empowerment for service users and carers or at the very least it was not as important to service providers as it was to service users and carers. (I acknowledge that this is conjecture on my part). Reading the findings highlights that the participants did feel empowered so it could be that the other service providers were committed to doing the job well but had no additional time to participate in this study. (This highlights the importance of the reader not jumping to conclusions about aspects of the study they can only speculate about). I was intrigued that one of the service providers commented that the meetings were more respectful than meetings that only involve service providers; the respondent commented “maybe all of us are making more of an effort to really hear what the others in the room are saying” (p225).

The findings related to systemic obstacles and negotiating power provided a lot of food for thought and we a useful counterbalance to the enabling opportunities enunciated first. The only thing I struggled with in reading the paper was the jump from discussing shared decision making to the concept of group occupations. The shift from to classifying this as a group occupation was not explored in detail and I am not sure I agreed with this link. This is a minor point in an otherwise excellent study.

Overall this is a thorough report of a rigorously conducted study which I think will be of value to most, if not all, of RCOMH’s subscribers. If nothing else, and this was not what the paper was about, it does provides an important reminder of the primacy housing and shelter for being able to engage in occupations.

The full reference for the paper is: Basiletti M, Townsend E (2012) Group decision-making in an intersectoral mental health community partnership British Journal of Occupational Therapy 75 (5) 223-229.