A voice for the patients: Evaluation of the implementation of a strategic organizational committee for patient engagement in mental health

Abstract

Objective: There is a need for structure to achieve functional patient engagement within mental healthcare organizations, and for clarification on how to proceed on a strategic level. The aim of this paper is to shed light on the implementation of a strategic organizational structure for patient engagement in mental health by examining why and how to implement a structure, the organizational and environmental factors that facilitate or limit the process, and the perceived consequences of the implementation.

Method: This paper evaluates the implementation of a strategic committee for patient engagement in a mental healthcare organization in Montreal (Quebec, Canada). The research was designed as a qualitative single case study using a deductive approach by means of a conceptual framework. Data sources consisted in ten semi-structured interviews, three focus groups, and organizational documents.

Results: The strategic committee for patient engagement was implemented as a means to formalize patient partner participation, following the introduction of a vision of full citizenship. Important aspects of its implementation included its composition and role, the elaboration of a framework for patient partner participation, and finally, ongoing application and evaluation of the framework. Several facilitating factors were identified, including executive management support, leadership, and a vision behind the participation. Limiting factors mainly consisted of resistance towards patient participation and the existence of stigma. Consequences included increased and improved patient engagement, as well as reduced stigma within the organization.

Conclusion: This study shows that the implementation of a strategic organizational structure for patient engagement is comprehensive. It further shows the importance of a vision and an articulate leadership involving several actors. Further research is needed regarding the impact of this type of strategic structure on a clinical level.

Fig 1. Framework to study the implementation of a strategic structure for patient engagement in mental health.

The inner sphere illustrates the organization where the implementation process of the structure takes place, while the outer sphere refers to the environment of the organization. Both spheres contain factors influencing the process. The stages of the implementation process belong to initiation (I) or operationalization (O) of the structure. The consequences of the implementation are situated to the right. (Adapted from Rogers [33], Pomey et al. [35], Brooks et al. [32] and Mendel et al. [36]).