The Patient Engagement Project addresses the need for patient engagement and patient-centred care by increasing meaningful patient engagement and participation in the design, delivery, and evaluation of services at the BC Forensic Psychiatric Hospital.
Certain characteristics of a forensic mental health inpatient setting, such as the correctional and public safety-oriented milieu, create serious challenges in engaging patients in their own care. This is problematic, since it is generally recognized that a participatory and collaborative care approach is important for achieving high-quality and effective mental health services, and is a key ingredient for the concept of 'procedural justice’.
Recognizing the need for patients to actively participate in care processes, the BC Mental Health & Substance Use Services (BCMHSUS) strategic plan identified a need to engage “clients as partners in planning, service decisions and in evaluation of our programs.” Specific to the BC Forensic Psychiatric Services Commission (FPSC), the plan identified the strategic goal of “further establishing clinical service models that are evidence-based and firmly patient-centred.”
The Patient Engagement Project (PEP), was designed to address this need for patient engagement and patient-centred care by increasing meaningful patient engagement and participation in the design, delivery, and evaluation of services at the BC Forensic Psychiatric Hospital (BC FPH).
The BC FPH is a 190-bed secure facility in British Columbia (BC), Canada. Patients of the BC FPH include individuals with severe mental illness who have been found ‘Not Criminally Responsible on account of Mental Disorder’ or ‘Unfit to Stand Trial’. In 2010, funding was obtained from the Canadian Health Services Research Foundation (CHSRF) in order to build and strengthen patient engagement at the BC FPH.
Over a 2-year period, 3 patient engagement initiatives were implemented and evaluated at the BC FPH. The overall objective of the project was to improve the experience of care by increasing opportunities for patient engagement in the design, delivery, and evaluation of services.
Using a Participatory Action Research (PAR) approach, Team P.E.E.R. (Patients Empowered & Engaged as Researchers) was made up of a diverse group of eight co-researchers. These co-researchers were adults who were diagnosed with a mental illness and were receiving treatment services at the BC Forensic Psychiatric Hospital (BC FPH). The team designed and implemented a research project on a topic they deemed meaningful and important to them regarding their experience of care at the BC FPH. In this initiative, patients were placed in the driver’s seat of a study as co-researchers.
PAR is emerging as an important way of working with individuals who are members of a marginalized social group, including people with mental health and substance use problems. Previous research suggests that patients are likely to experience several benefits from being involved in the Team P.E.E.R., including increased confidence, enhanced knowledge and skills, better self-efficacy and self-esteem, and an improved sense of empowerment.
Livingston, J.D., Nijdam-Jones, A., Lapsley, S., Calderwood, C., & Brink, J. (2013). Supporting recovery by improving patient engagement in a forensic mental health hospital: results from a demonstration project. Journal of the American Psychiatric Nurses Association, 19(3):132-45. doi: 10.1177/1078390313489730.