Experts by experience in mental health nursing education: What have we learned from the COMMUNE project?

The COMMUNE (co-produced mental health nursing education) was an international project established to embed EBE perspectives in mental health nursing education by developing and delivering a specific mental health nursing module. The underlying intention of this project was to go well beyond ad hoc implementation and tokenistic approaches to EBE involvement. Standards for co-production of Education (Mental Health Nursing) (SCo-PE [MHN]) was developed to provide guidance to the increasing number of academics seeking genuine and meaningful involvement of Experts by Experience in the education of health professionals. These standards were recently published in the Journal of Mental Health and Psychiatric Nursing (Horgan et al., 2020): https://onlinelibrary.wiley.com/doi/abs/10.1111/jpm.12605 and prompted this Editorial to discuss the COMMUNE project more fully, including the lessons learned

Practice Guidelines for Co-Production of Mental Health Nursing Education

COMMUNE (Co-production of Mental Health Nursing Education) is an Erasmus+ Strategic Partnership Project based on the collaboration of experts by experience (EBE) and mental health nursing academics from six European universities and the University of Canberra in Australia. Its purpose was to advance the involvement of those who have experiences of mental health service use (EBE) in mental health nursing education. The project combined experiential and academic knowledge, with the aim of co-producing a module on ‘mental health recovery’ for undergraduate nursing students; a module that was taught to the students by EBE. Principles of co-production where followed as much as possible, involving EBE in all stages of the process, from grant application to dissemination. The project tried to move beyond typical service user involvement and towards co-creation of knowledge, where power differentials are acknowledged and equity issues addressed. Barriers to meeting these goals were experienced and will be discussed in this Guidelines. We hope that these Practice Guidelines will be useful for those who intend to co-produce learning programs or modules in mental health nursing and inspire others to follow similar paths and learn from our experiences, positive or otherwise. These Guidelines provide an overview of our experiences, learnings, limitations and barriers.The Commune team decided on the term ‘Expert by Experience’ (EBE) to describe the members of the team and other collaborators who has lived experience of mental distress. Other more commonly used terms are ‘service user’, ‘consumer’ and ‘people with mental illness.’ As not all experts by experience are mental health care users, and what constitutes an illness is highly debated, the team decided on a term that more correctly describes and value lived experience.Erasmus

Kokemusasiantuntijat mielenterveys- ja päihdetyön opettajina : uusi innovaatio

Turun ammattikorkeakoulun terveys- ja hyvinvointialalla on tehty vuosia yhteistyötä mielenterveyspalveluita käyttävien kokemusasiantuntijoiden kanssa. Osana kansainvälistä Commune-hanketta suunniteltiin yhdessä kokemusasiantuntijoiden kanssa yhden opintopisteen koulutuskokonaisuus mielenterveyshoitotyöstä sairaanhoitajaopiskelijoille

‘It is meant to be heart rather than head’; International perspectives of teaching from lived experience in mental health nursing programs

Consumer participation is a clear expectation of contemporary mental health policy. Most activity has concentrated in direct service delivery, and academic roles for mental health consumers have been slow to establish. An international project was undertaken to implement and evaluate meaningful consumer involvement in mental health nursing education. A learning module was co-produced between ‘Experts by Experience’ (drawing on experience of mental distress and service use) and Mental Health Nurse Academics. This qualitative exploratory study aimed to capture how Experts by Experience perceive their contribution. Interviews were undertaken with Experts by Experience who delivered the learning module. Data were analysed thematically and subsequently interpreted with Critical Social Theory. Two main themes emerged from the findings: ‘there wasn't a barrier’ described how personal narratives enhanced relationships between Experts by Experience and students; and ‘made the human being visible’, described their experiences of allowing students to see the person behind a diagnosis. These findings suggest Experts by Experience teaching is valuable and potentially a tool in redressing stigma. Addressing poor public perceptions could attract higher numbers of quality practitioners to mental health and meet identified workforce shortages. The findings presented here strengthen the evidence base for Expert by Experience roles in mental health professional education. These findings can be considered in international curricula reviews and aid progress towards a more socio-political, humanistic focus in mental health nursing, congruent with rights-based reform agendas

‘It is meant to be heart rather than head’:International perspectives of teaching from lived experience in mental health nursing programs

Consumer participation is a clear expectation of contemporary mental health policy. Most activity has concentrated in direct service delivery, and academic roles for mental health consumers have been slow to establish. An international project was undertaken to implement and evaluate meaningful consumer involvement in mental health nursing education. A learning module was co-produced between 'Experts by Experience' (drawing on experience of mental distress and service use) and Mental Health Nurse Academics. This qualitative exploratory study aimed to capture how Experts by Experience perceive their contribution. Interviews were undertaken with Experts by Experience who delivered the learning module. Data were analysed thematically and subsequently interpreted with Critical Social Theory. Two main themes emerged from the findings: 'there wasn't a barrier' described how personal narratives enhanced relationships between Experts by Experience and students; and 'made the human being visible', described their experiences of allowing students to see the person behind a diagnosis. These findings suggest Experts by Experience teaching is valuable and potentially a tool in redressing stigma. Addressing poor public perceptions could attract higher numbers of quality practitioners to mental health and meet identified workforce shortages. The findings presented here strengthen the evidence base for Expert by Experience roles in mental health professional education. These findings can be considered in international curricula reviews and aid progress towards a more socio-political, humanistic focus in mental health nursing, congruent with rights-based reform agendas

Something special, something unique: Perspectives of experts by experience in mental health nursing education on their contribution

4.1 Introduction: Embedding lived experience in mental health nursing education is increasing, with research findings suggesting the impact is positive. To date, research has primarily targeted the perspectives of nursing students and academics from the health professions. 4.2 Aim: To enhance understanding of the unique knowledge and expertise experts by experience contribute to mental health nursing education. 4.3 Methods: Qualitative exploratory research methods were employed. In-depth individual interviews were conducted with experts by experience who delivered a coproduced learning module to nursing students in Europe and Australia. 4.4 Results: Participants described their unique and essential contribution to mental health nursing education under four main themes: critical thinking, beyond textbooks; interactive and open communication; understanding personal recovery; and mental health is health. 4.5 Conclusions: These findings present an understanding of the unique knowledge and expertise Experts by Experience contribute to mental health education not previously addressed in the literature. Appreciating and respecting this, unique contribute is necessary as Expert by Experience contributions continue to develop. 4.6 Implications for Practice: Mental health services purport to value service user involvement. Identifying and respecting and valuing the unique contribution they bring to services is essential. Without this understanding, tokenistic involvement may become a major barrier

“I felt some prejudice in the back of my head”:Nursing students’ perspectives on learning about mental health from “Experts by Experience”

WHAT IS KNOWN ON THE SUBJECT?: Consumer participation in mental health services is embedded in mental health policy in many countries. The negative attitudes of nurses and other health professionals to consumer participation poses a significant obstacle to this policy goal Involving mental health "Experts by Experience" in the education of nursing students demonstrates positive attitudinal change WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: More detailed understanding of nursing students' experiences and perspectives about being taught mental health nursing by "Experts by Experience" An international focus, extending understandings about how Experts by Experience might be perceived in a broader range of countries WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Positive attitudes towards people labelled with mental illness are essential for quality nursing practice Nurses have an important leadership role in facilitating consumer participation within health services. It is critical that their attitudes are professional and optimistic. ABSTRACT: Introduction Consumer participation is central to mental health policy. Negative attitudes of health professionals are barriers to realizing policy goals. Evidence suggests consumers (Experts by Experience) can influence positive attitudes in nursing students. Research in this area to date is limited and primarily from Australia and New Zealand. Aim To enhance understanding of nursing students' perspectives and experiences of being taught mental health by an Expert by Experience. Method A qualitative exploratory approach was used. Focus groups were conducted with nursing students from seven universities in Australia and Europe. Data were analysed thematically. Results Student participants described how exposure to Experts by Experience challenged their views and attitudes and provided a mechanism for reflection, critique and change. The main theme "changing mindset" includes two subthemes: exposing stereotypes and reflection. Discussion This unique international study demonstrates the capacity for Experts by Experience to contribute to positive attitudinal change towards mental illness in nursing students. This changed mindset must occur for policy goals to be realized. Implications for practice Nurses in all areas of practice will work with people labelled with mental illness and experiencing mental distress. Overcoming stereotypes and adopting more positive attitudes is essential to deliver quality mental health care

‘There's more to a person than what's in front of you’:Nursing students’ experiences of consumer taught mental health education

Holistic and person-centred nursing care is commonly regarded as fundamental to nursing practice. These approaches are complementary to recovery which is rapidly becoming the preferred mode of practice within mental health. The willingness and ability of nurses to adopt recovery-oriented practice is essential to services realizing recovery goals. Involving consumers (referred herein as Experts by Experience) in mental health nursing education has demonstrated positive impact on the skills and attitudes of nursing students. A qualitative exploratory research project was undertaken to examine the perspectives of undergraduate nursing students to Expert by Experience-led teaching as part of a co-produced learning module developed through an international study. Focus groups were held with students at each site. Data were analysed thematically. Understanding the person behind the diagnosis was a major theme, including subthemes: person-centred care/seeing the whole person; getting to know the person, understanding, listening; and challenging the medical model, embracing recovery. Participants described recognizing consumers as far more than their psychiatric diagnoses, and the importance of person-centred care and recovery-oriented practice. Understanding the individuality of consumers, their needs and goals, is crucial in mental health and all areas of nursing practice. These findings suggest that recovery, taught by Experts by Experience, is effective and impactful on students' approach to practice. Further research addressing the impact of Experts by Experience is crucial to enhance our understanding of ways to facilitate the development of recovery-oriented practice in mental health and holistic and person-centred practice in all areas of health care