Co-production in mental health care: the first results of an explorative study

Co-production is a relationship between a paid employee of an organization and (groups of) individual citizens that requires a direct and active contribution from these citizens to the work of the organization. In its early... [ view full abstract ]

Co-production is a relationship between a paid employee of an organization and (groups of) individual citizens that requires a direct and active contribution from these citizens to the work of the organization. In its early days, research on this topic consisted of early explorations of the topic – particularly associated with the work of Ostrom and later Pestoff and Alford. More recently, a number of methodologically more diverse and sceptical studies emerged examining specific aspects of co-production. This has begun to open up areas that were until recently black boxes. One of these is how co-production affects the employee-client relationship and whether the outcomes meet different expectations.

Research on co-production in public services has logically focused primarily on those areas where the involvement of clients and/or their families has been largest, such as safety, education and childcare. Now we are also seeing the emergence of studies in areas where co-production feels less natural, where traditionally professionals dominate, or are thought to dominate. This is of course the acid test of co-production: does it replicate the flaws of classical participation, where highly educated, self-reliant citizens dominate; or does it help to actively involve those that we usually think of as dependent? Mental health care is a difficult, but logical and critical area to test this.

The paper presented in Edinburgh will present the first results of research on co-production in mental health care in The Netherlands to answer the question whether and how organizational, professional or case-related factors affect the (non)-use of co-production practices. The research was based on a combination of closed survey questions and vignettes an approach combining the virtues of an experimental design with the breadth of a survey. Therapists having experience with different client populations and diagnoses were involved in our study. Variables on which data were collected were personal therapist data (age, gender, educational background, work history in the organisation), the perceived effect of protocols, perceived professional autonomy, perceived organisational support, self-efficacy, perceived measures and expectations of success, the role of new technologies and medical competence (specifically, the ability to understand what choices in the treatment entail). These indicators were combined and operationalised on the basis of past co-production research in other fields and psychiatric research.