Co-designing and co-producing support during and following inpatient care: Mental health service users and social workers working as allies

BACKGROUND: Internationally, in the wake of de-institutionalisation, there has been a steady move towards recovery-oriented practice in mental health services. People who use mental health services have advocated for changes in service models and structures, and for a greater say in how services are delivered. Recently there has been a move to employ people with lived experience as peer workers; not in lone patient representative roles of 20 years ago but as colleagues delivering practice interventions. This is still highly controversial in acute psychiatry.

AIMS: To share a model and outcomes from the Expanding Post Discharge support Initiatives (EPDI) – peer support workers supporting service users to transition from adult acute inpatient mental health to the community. The aims were to reduce unplanned re-admission and inpatient length of stay (LOS), achieve more timely discharge, and maintain recovery gains people have made during admission throughout the post discharge period of the next 28 days.

METHODS: Establishing the EPDI involved recruiting peer support workers, gaining training in Mead’s intentional peer support model, and developing processes for monitoring and reporting.

RESULTS: Over 150 people with lived experience of mental illness have received support through EPDI since August 2015. EPDI has achieved the aims to reduce unplanned re-admission and LOS. It provides enhanced psychosocial focus in multidisciplinary decision making in discharge planning. For people who use services, EPDI has reduced the impact of mental illness and use of inpatient services, increasing self-efficacy, improving practical outcomes in employment, housing and finances, and increased community and social inclusion.

DISCUSSION / CONCLUSION: Under the conference theme of ‘service user and survivor research’, we will explain how peer workers and social workers can work with people with lived experience of mental illness to achieve positive outcomes and sustained recovery progress and community connection, reducing social isolation, after acute illness.