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.