Riga Presentation v2

Embed Size (px)

Text of Riga Presentation v2

  1. 1. Co-production in Secure Settings Frank Reilly
  2. 2. Definition that works in forensic settings Examples Methods Early results Toward skills Project Objectives
  3. 3. Background: High Secure Settings Restricted liberties Required programme of care Managing risk a high priority Dual purpose: protect the public/patients and provide mental health care
  4. 4. Co-production is a slippery concept (Adults Services: SCIE Guide 51) -in high secure settings it can also be threatening Background: Definitions
  5. 5. Co-production assumes that individuals have: *Assets that can be engaged in achieving self actualisation (Harrison et al 2004) *Potential for increasing independence and citizenship or social responsibility(Gershon 2004, Lyons 2006) *Potential for the reduction of reliance on formal care and agencies(Boyle and Harris 2009, Leadbetter 2004)
  6. 6. To be truly transformative, co-production requires a relocation of power towards service users. This necessitates new relationships with front-line professionals who need training to be empowered to take on these new roles (Realpe and Wallace 2010, p3)
  7. 7. Examples: Ward talking groups No explicit rules....but the participants create them Hierarchy suspended Not assessed Engages
  8. 8. Co-production exists when trust, the support of autonomy and the sharing of knowledge as power (both from and to the patient) result in outcomes that are personal to the patient/client.
  9. 9. Issues Importance of relational security Managing complex and shifting boundaries Reaction to failures/complacency
  10. 10. Potential Benefits Reinforces hope Improved understanding Reduce violent incidents Improve engagement in treatment
  11. 11. Project in action:Methods 2x low secure sites (1x NHS, 1x private) 1x High Secure site Potential comparison site in Ireland Staff focussed (ethical issues)
  12. 12. Project in action: Methods Purposive sample of recovery oriented staff 6x semi-structured interviews each site (n=18) 1xvignette focus group each low secure site 2x iterations of Delphi questionnaire (wisdom of crowds)
  13. 13. Project in action: Early results Relational security relies on apprentiship Private clinic restructured: values based for relational skills Difference between staff who rely on structure to those who build on it Organisation who value social therapy reap benefits: lower assaults, better engagement
  14. 14. Where is the fit? Relational security Co-production Recovery
  15. 15. The challenge? Organisations that don't co-produce with their staff find it difficult to facilitate co-production with their consumers