title: Bringing meaning to user involvement in mental health care planning: a qualitative exploration of service user perspectives.
abstract: BACKGROUND
  Service users wish to be involved in care planning but typically feel marginalized in this process. Qualitative explorations of the barriers and enablers of user involvement in mental health care planning are limited.
  
  
  OBJECTIVE
  How is user involvement in care planning conceptualized by service users and how can meaningful involvement be instilled in the care planning process?
  
  
  METHODS
  In 2013, we conducted five focus groups (n = 27) and 23 individual interviews with current or recent adult users of secondary care mental health services (n = 27) in England. Eight users participated in both. Data were analysed using Framework Analysis. Results Ten themes emerged from the data: these themes encompassed procedural elements (connection; contribution; currency; care consolidation; and consequence), service user characteristics (capacity and confidence) and professional enablers (consultation; choice; and clarity of expression). Procedural elements were discussed most frequently in service user discourse.
  
  
  CONCLUSIONS
  The process of care planning, centred on the user-clinician relationship, is key to user involvement.
  
  
  CONCLUSIONS
  Users describe a common model of meaningful involvement in care planning. Their requests, summarized through a 10C framework of care planning involvement, provide clear direction for improving service users satisfaction with care planning and enhancing the culture of services.
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Grundy
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: P
authors.initials: P
authors.lastname: Bee
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: O
authors.initials: O
authors.lastname: Meade
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, UK.
authors.forename: P
authors.initials: P
authors.lastname: Callaghan
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Beatty
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: N
authors.initials: N
authors.lastname: Olleveant
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
authors.forename: K
authors.initials: K
authors.lastname: Lovell
mesh_terms: D000328:Adult; D006801:Humans; D008605:Mental Health Services; D010347:Patient Care Planning; D010358:Patient Participation; D011369:Professional-Patient Relations; D036301:Qualitative Research
keywords: patient experience; qualitative methodology; user involvement