title: Carers' experiences of involvement in care planning: a qualitative exploration of the facilitators and barriers to engagement with mental health services.
abstract: BACKGROUND
  Formal recognition and involvement of carers in mental health services has been the focus of recent policy and practice initiatives as well as being supported by carers themselves. However, carers still report feeling marginalised and distanced from services. A prominent theme is that that they are not listened to and their concerns are not taken seriously. Compared to service user views, the reasons underpinning carers' dissatisfaction with care-planning procedures have been relatively neglected in the research literature, despite the substantial and significant contribution that they make to mental health services. The aim of the study was to explore carers' experiences of the care planning process for people with severe mental illness.
  
  
  METHODS
  Qualitative interviews and focus groups were undertaken with carers. Data were combined and analysed using framework analysis.
  
  
  RESULTS
  Whilst identifying a shared desire for involvement and confirming a potential role for carers within services, our data highlighted that many carers perceive a lack of involvement in care planning and a lack of recognition and appreciation of their role from health professionals. Barriers to involvement included structural barriers, such as the timing and location of meetings, cultural barriers relating to power imbalances within the system and specific barriers relating to confidentiality.
  
  
  CONCLUSIONS
  This qualitative study led by a researcher who was a carer herself has developed the understanding of the potential role of carers within the care planning process within mental health services, along with the facilitators and barriers to achieving optimal involvement.
authors: EQUIP, School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. lindsey.cree@postgrad.manchester.ac.uk.
authors: Lindsey
authors: L
authors: Cree
authors: EQUIP, School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. helen.brooks@manchester.ac.uk.
authors: Helen L
authors: HL
authors: Brooks
authors: School of Healthcare, University of Leeds, ᅟ, Leeds, LS2 9JT, UK. k.m.berzins@leeds.ac.uk.
authors: Kathryn
authors: K
authors: Berzins
authors: EQUIP, School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. claire.fraser@manchester.ac.uk.
authors: Claire
authors: C
authors: Fraser
authors: EQUIP, School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. karina.lovell@manchester.ac.uk.|Manchester Mental Health and Social Care Trust, University of Leeds, ᅟ, Manchester, ᅟ, UK. karina.lovell@manchester.ac.uk.
authors: Karina
authors: K
authors: Lovell
authors: EQUIP, School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. penny.bee@manchester.ac.uk.
authors: Penny
authors: P
authors: Bee
mesh_terms: D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003219:Confidentiality; D004644:Emotions; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D010347:Patient Care Planning / Q000458:organization & administration*; D036301:Qualitative Research