How do consumer leaders co-create value in mental health organisations?Brett Scholz A B , Julia Bocking A and Brenda Happell A
A SYNERGY Nursing and Midwifery Research Centre, University of Canberra and ACT Health, The Canberra Hospital, Garran, ACT 2605, Australia. Email: firstname.lastname@example.org; email@example.com
B Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - http://dx.doi.org/10.1071/AH16105
Submitted: 21 April 2016 Accepted: 30 July 2016 Published online: 23 September 2016
Objectives Contemporary mental health policies call for consumers to be involved in decision-making processes within mental health organisations. Some organisations have embraced leadership roles for consumers, but research suggests consumers remain disempowered within mental health services. Drawing on a service-dominant logic, which emphasises the co-creation of value of services, the present study provides an overview of consumer leadership within mental health organisations in the Australian Capital Territory.
Methods Mental health organisations subscribing to the local peak body mailing list were invited to complete a survey about consumer leadership. Survey data were summarised using descriptive statistics and interpreted through the lens of service-dominant logic.
Results Ways in which organisations may create opportunities for consumers to co-create value within their mental health services included soliciting feedback, involving consumer leaders in service design, having consumer leaders involved in hiring decisions and employing consumer leaders as staff or on boards. Strategies that organisations used to develop consumer leaders included induction, workshops and training in a variety of organisational processes and skills.
Conclusions The findings of the present study extend the application of a service-dominant logic framework to consumer leadership within mental health organisations through consideration of the diverse opportunities that organisations can provide for consumer co-creation of service offerings.
What is known about the topic? Policy calls for consumer involvement in all levels of mental health service planning, implementation and delivery. The extent to which service organisations have included consumer leaders varies, but research suggests that this inclusion can be tokenistic or that organisations choose to work with consumers who are less likely to challenge the status quo. Service literature has explored the way consumers can co-create value of their own health care, but is yet to explore consumers’ co-creation of value at a systemic level.
What does the paper add? This paper outlines ways in which mental health organisations report involving consumers in leadership positions, including having consumers on boards, having consumers on recruitment panels and providing leadership training for consumers. These initiatives are considered in terms of the potential value co-created within mental health services by consumers in leadership, suggesting that consumer leaders are a resource to mental health organisations in terms of the value brought to service offerings.
What are the implications for practitioners? Research suggests that medical professionals have been resistant to increased consumer leadership within mental health services. The findings of the present study emphasise the value that can be brought to service organisations by consumer leaders, suggesting that mental health practitioners may reconsider their approach and attitudes towards consumer leadership in the sector.
Additional keywords: consumer participation, partnership.
References Gee A, McGarty C, Banfield M. What drives systemic mental health advocates? Goals, strategies, and values of Australian consumer and carer advocacy organizations. SAGE Open 2015; 5 2158244015615384
 Mental Health Commission of Canada. Changing directions, changing lives: The mental health strategy for Canada. Alberta: Mental Health Commission of Canada; 2012.
 World Health Organization (WHO). Policies and practices for mental health in Europe – meeting the challenges. Copenhagen: WHO; 2008.
 Department of Health. National mental health policy. Canberra: Commonwealth of Australia; 2009.
 Gordon S. The role of the consumer in the leadership and management of mental health services. Australas Psychiatry 2005; 13 362–5.
| The role of the consumer in the leadership and management of mental health services.CrossRef | 16403131PubMed |
 Meagher J. Changing perspectives on consumer involvement in mental health. Health Voices: J Consumers Health Forum Aust 2011; 27–8.
 Bennetts W, Pinches A, Paluch T, Fossey E. Real lives, real jobs: sustaining consumer perspective work in the mental health sector. Adv Mental Health 2013; 11 313–25.
 Happell B, Roper C. The myth of representation: the case for consumer leadership. AeJAMH 2006; 5 177–84.
| The myth of representation: the case for consumer leadership.CrossRef |
 O’Hagan M. Leadership for empowerment and equality: a proposed model for mental health user/survivor leadership. Int J Leadersh Public Serv 2009; 5 34–43.
 Cleary M, Walter G, Escott P. ‘Consumer consultant’: expanding the role of consumers in modern mental health services. Int J Ment Health Nurs 2006; 15 29–34.
| ‘Consumer consultant’: expanding the role of consumers in modern mental health services.CrossRef | 16499788PubMed |
 Sharma S, Conduit J, Rao Hill S. Organisational capabilities for customer participation in health care service innovation. Australas Mark J 2014; 22 179–88.
| Organisational capabilities for customer participation in health care service innovation.CrossRef |
 Brown LD, Townley G. Determinants of engagement in mental health consumer-run organizations. Psychiatr Serv 2015; 66 411–17.
| Determinants of engagement in mental health consumer-run organizations.CrossRef | 25554965PubMed |
 Austin E, Ramakrishnan A, Hopper K. Embodying recovery: a qualitative study of peer work in a consumer-run service setting. Community Ment Health J 2014; 50 879–85.
| Embodying recovery: a qualitative study of peer work in a consumer-run service setting.CrossRef | 24464104PubMed |
 Segal SP, Silverman CJ, Temkin TL. Self-stigma and empowerment in combined-CMHA and consumer-run services: two controlled trials. Psychiatr Serv 2013; 64 990–6.
| Self-stigma and empowerment in combined-CMHA and consumer-run services: two controlled trials.CrossRef | 23771604PubMed |
 Felton BJ. Defining location in the mental health system: a case study of a consumer-run agency. Am J Community Psychol 2005; 36 373–86.
| Defining location in the mental health system: a case study of a consumer-run agency.CrossRef | 16389506PubMed |
 McCoy ML, Aronoff M. Against all odds: revitalization of local self-help alternatives by longterm mental health consumers. Qual Sociol 1994; 17 365–81.
| Against all odds: revitalization of local self-help alternatives by longterm mental health consumers.CrossRef |
 McLean A. Empowerment and the psychiatric consumer/ex-patient movement in the United States: contradictions, crisis and change. Soc Sci Med 1995; 40 1053–71.
| Empowerment and the psychiatric consumer/ex-patient movement in the United States: contradictions, crisis and change.CrossRef | 1:STN:280:DyaK2MzitVKitA%3D%3D&md5=cf512e9098c1aafe701e4ba42fec1709CAS | 7597459PubMed |
 Salem DA, Reischl TM, Randall KW. The effect of professional partnership on the development of a mutual-help organization. Am J Community Psychol 2008; 42 179–91.
| The effect of professional partnership on the development of a mutual-help organization.CrossRef | 18668362PubMed |
 Scholz B, Gordon S, Happell B. Consumers in mental health service leadership: a systematic review. Int J Ment Health Nurs 2016;
| Consumers in mental health service leadership: a systematic review.CrossRef | 26748945PubMed |
 Joiner KA, Lusch RF. Evolving to a new service-dominant logic for health care. Innovation Entrepreneurship Health 2015; 3 25–33.
 Vargo SL, Lusch RF. Institutions and axioms: an extension and update of service-dominant logic. J Acad Mark Sci 2016; 44 5–23.
| Institutions and axioms: an extension and update of service-dominant logic.CrossRef |
 McColl-Kennedy JR, Vargo SL, Dagger TS, Sweeny JC, van Kasteren Y. Health care customer value cocreation practice styles. J Serv Res 2012; 15 370–89.
| Health care customer value cocreation practice styles.CrossRef |
 ACT Mental Health Consumer Network. Strategic plan 2013–2016. Canberra: ACT Mental Health Consumer Network; 2013.
 Mental Health Community Coalition of the ACT Inc. Annual report 2014–2015. Canberra: Mental Health Community Coalition of the ACT Inc.; 2015.
 Australian Institute of Health and Welfare (AIHW). Mental health services in brief. Canberra: AIHW; 2011.
 White U, Gilbert C, Johansen G. Mental health in the ACT. Canberra: ACT Department of Health and Community Care; 1997.
 Onken SJ, Dumont J, Ridgway D, Ralph R. Contextualizing self-determination within a mental health recovery oriented service and support system. In: Jonikas JA, Cook JA, editors. Proceedings of The National Self-determination and Psychiatric Disability Invitational Conference; 2-3 October 2003; Chicago, USA. Chicago: The UIC National Research and Training Center on Psychiatric Disability.
 Lewis SE, Hopper K, Healion MA. Partners in recovery: Social support and accountability in a consumer-run mental health center. Psychiatr Serv 2012; 63 61–5.
| Partners in recovery: Social support and accountability in a consumer-run mental health center.CrossRef | 22227761PubMed |