Edinburgh Napier University

  Serious mental health problems among young people are on the increase in Western
countries. Involving young people in their mental health care, and working in partnership
with them during the treatment process, is a primary concern of all mental health services;
their parents have also been promised a place in the health care team.
Research into the process and outcomes of hospitalisation of young people in specialist
mental health units is complex and therefore limited. Qualitative investigations into the
experience of young people as users of these services are few. Making use of ethnographic
methods, this study explored young people and their carers' (both parents and staft)
experience regarding treatment and participation in decision-making in four Scottish
adolescent inpatient or day-care mental health units.
The findings suggest that the young people (n = 18) valued the personalised relationships
they developed with the staff and their peers and that if these relationships were
empowering, they facilitated both treatment and participation in treatment. However, the
findings also show that the parents (n = 16) and staff members (n = 21) were sometimes
disempowered and that this impaired the overall participative nature of the units. The unit
culture was an important contributor to the effectiveness of young people and parent involvement.
Making use of concepts from the neighbouring academic field of pastoral theology to
interpret the findings, the study concludes with a conceptual framework of what is required
for a unit to be more participative. This theoretical framework adds significant elements to
the existing knowledge regarding participation in adolescent mental health units. It places
relationships of justice and care between all stakeholders at the core of successful
participation, hereby drawing attention to the importance of humanistic and ethical
considerations in user and carer involvement.