This chapter by Anita Bowser is summarised here. She covers Recovery and details initiatives to engage service users and to promote user involvement.

1. Gerard Drennan and Deborah Alred (Eds) ‘Secure Recovery’ (2012)
Chapter 3 by Anita Bowser
‘Nothing for us without us either’ – forensic service user involvement
Service user involvement is an essential component of recovery-oriented
services. This chapter is about the development of a
particular service, at Hampshire Partnership NHS Foundation Trust.
Anita puts service configuration in the context of official policies.
(Me: do many carers know about the NSF etc?) To engender SU
involvement is a challenge for clinicians. There is acceptance of SU’s
telling their stories within the Trust, and to this end a Consumer
Advisor role with associates has been established. Called Quality
Network, it is empowering for individuals to work and be paid.
Some staff see their role in detention, not helping recovery. SU
initiatives have brought about involvement in developing the service.
With plenty of tea and biscuits at meetings, and staff support,
there have been moves to improve user involvement at ward rounds
and CPA meetings. Volunteer roles (Ward Reps) have become paid,
Trust Band 1. What some people may have been waiting for,
indiscipline among ward reps, has occurred with some dismissed for
drug taking. However for those ward reps who perform well, they
get a positive to impart for employers, when they will have to cope
with a criminal record and mental health history.
SU’s sit on interview panels and the Reference Group have drawn up
a list of questions to be used at staff interviews. There are issues
of confidentiality when SU’s sit on interview panels. OT’s now have a
policy of asking candidates to present on user involvement to SU’s.
Anita quotes the Sainsbury Centre who state that professionals at
all levels can have training that is user-led.
Anita states one of the principles of recovery-oriented practice as
informed choice through empowering regaining of control.

2. SU involvement at MDT meetings: there is the issue of third party
information, and if SU’s can be present when this is discussed. Ward
rounds have been renamed ‘progress reviews’ and positives are
focussed on, and strengths, rather that problems. CPA was
introduced in 1991, and after the ‘Having Your Say’ consultation at
Ravenswood House at Hampshire Trust, changes were made to the
advantage of SU’s. These include having a separate part of the
meeting where third party issues are discussed and then a part with
the SU, who will be involved in writing her or his care plan. SU
strengths and expertise included the example of one SU who was
expert at golf and who gave golf classes. Having a job mitigates
against the demoralisation of being locked up. Barriers to
employment include fatigue. There is mention of Individual
Placement and Support, also Supported Permitted Employment. At
Ravenswood there are employment contracts for SU’s, however
increases in benefits make employment less attractive. It is also the
work environment that enables steps towards Recovery. Even if only
for one hour per week, a job can make SU’s feel important,
testified by more than one SU in quotes.
Meaningful SU involvement is helpful to Recovery, as is equality at
clinical meetings.
Barriers to embedding SU involvement include staff attitudes that
focus on problems, however there are many advantages to a multi-faceted
approach to SU involvement, in enabling Recovery oriented
practice.