Towards expertise-by-experience in mental health care: evaluation of a recovery-oriented training of (ex-)users of mental health care services

Background/Objectives: In Belgium, a 4-year training exists to become a certified expert-by-experience in Poverty. The development of a similar training to become an expert-by-experience in Mental Health Care is planned in collaboration with the platforms of users of Mental Health Care and their family members. The different roles as expert-by-experience and the necessary competences are being identified. The focus of the training will be on the representative role on different levels in mental health care (care, policy, research). The evaluation of a pilot training consisting of 4 afternoon sessions is important to determine the learning goals of candidates and for the further development and optimisation of this training.

Methods: Twelve (ex-)users of mental health services were selected from thirty candidates. The selection procedure was based on a questionnaire and an intake with two experts with experience in mental health care. The selection criteria were: availability, motivation, learning attitude, strengths and global impression of the candidate. The training sessions are built up around 4 topics: (a) the core value of expertise-by-experience (what is it? supplementary value? different roles and functions for the expert-by-experience); (b) integration of the own experiences (vision on recovery, empowerment, rehabilitation, stigmatization and discrimination); (c) knowledge about the mental health care sector (organization, patient rights, legal aspects); and (d) communication skills (assertiveness, active listening, effective speaking and meeting skills). Each training session is duo-coached by a professional (in mental health care, policy, and research) and an expert-by-experience in mental health care and is attended by an external observer. The training program is evaluated by the participants by means of a satisfaction questionnaire and a personal goal attainment scaling; by the observer by means of a description of the process based on the structured observations. At the end of the program, a workgroup consisting of the initiators, the trainers and the observer conducted a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis.

Results: The participants were globally very satisfied. Strengths: Participants stress the positive effect of the exchange of experiences with other participants. They appreciate the very concrete and practical information about the possibilities of working as an expert-by-experience and about the legal status of that position. Weaknesses: Participants have a limited interest in representing persons with psychiatric problems at an organizational or governmental level. For some of them, their personal preference to participate in mental health care as a caregiver is not a realistic goal at this stage of their recovery process. The expression by the participants of their need for support and coaching is consistent with the strategic plan to establish a long term training program. Although the program is directed to the specific strengths and needs of the individual participants, the selection of the candidates is no guarantee for success, as exemplified by the fact that one participant terminated prematurely the training program as it was too confronting in his current recovery process.

Discussion/Conclusions: The evaluation of a pilot training program towards expertise-by-experience in mental health care points at specific needs and challenges for the development of a long term training program.

Funding: King Baudoin Foundation.

Keywords: Recovery-oriented interventions, training programs, empowerment.