Abstract
BackgroundThere is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users’ views and co-production initiatives have had little impact on the development of interventions and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs.MethodsA co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data.ResultsParticipants reported some experiences of good practice but also of experiences of severely stigmatising interventions, a lack of effective support and service fragmentation. Relational Practice was identified as the central overarching theme and describes how community services can best support people with complex emotional needs. This approach involves care delivered in a non-stigmatising, individualised and compassionate way and care that is trauma-informed. It involves care that is planned collaboratively with service users to ensure their multiple needs are addressed in a flexible, holistic and consistent way which accounts for the long-term and fluctuating nature of their needs.ConclusionsRelational practice approaches have potential to facilitate better community care for people with complex emotional needs. Research and service development are needed to examine how best to implement such approaches across the mental health service system. This work must be co-produced with people with relevant lived experience, their carers and the professionals who support them.
Highlights
There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed
We aimed to recruit some people who had not received a ‘personality disorder’ diagnosis, all participants had received a diagnosis at some point in their life
Interpersonal connection We found that service users want to be supported by staff who treat them with respect and compassion, who listen with empathy and who validate their individual experiences
Summary
There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. Service users’ views and co-production initiatives have had little impact on the development of interventions and care This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs. Though some service users find the term helpful in explaining the nature of their needs, and it has had a role in ensuring consistency in research, many people find it unhelpful and do not identify with it With consideration of these ongoing and evolving debates, at the beginning of the project our team of experts came together to discuss and agree on a preferred alternative working term - complex emotional needs (CEN). In terms of being rather over-general, and advocate for further coproduced work to develop new ways of describing this need and on the best way of assessing people with these clusters of need
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