User Empowerment 13

Users interview users

(this article appeared in Openmind 102 March/April 2000)

Justine Morrison and Sarah Cook on a primary care user-satisfaction survey undertaken by service users

A Sheffield primary care service for people with severe mental health problems recently contracted local users to undertake a survey of user satisfaction. Pitsmoor Surgery was given permission to adapt the Verona Service Satisfaction Scale1 for use in primary care. The user-researchers achieved a 61 per cent response rate, and met the deadlines.
The role of the survey coordinator, responsible for the recruitment and training of interviewers, was vital. The coordinator provided support and encouragement to interviewers at all stages of the survey process. Formal debriefing sessions took place after each interview. The coordinator also performed a supervisory function to ensure that the interviewing schedule and agreed procedures were adhered to.
The interviewers had no previous experience of interviewing, but had good listening skills, an ability to be non-judgemental,
and a commitment to finding out users' opinions. One of the interviewers' main strengths was their ability to establish rapport with interviewees. The interviewers believe that their experience as mental health service users aided them in this process. Their sensitivity and sympathy put interviewees at ease.
To become a competent interviewer of users it is not enough to be a service user. Interviewing is a skilled job that requires training and support both before and after interviews. Training sessions on how to use the questionnaire, conduct face-to-face interviews and overcome communication difficulties are vital. In addition, the interviewer must possess specific skills and qualities, including the ability to concentrate on more than one thing at once, a preparedness to go at the interviewee's pace, an ability to put aside one's own issues and focus on the interview, and the resources to deal with the emotional impact of interviews.

At first, interviewers experienced some nervousness and lack of confidence due to their lack of experience. These feelings diminished as the interviewing schedule progressed. The skills they developed enabled them to achieve and maintain rapport, in sometimes trying circumstances, by exercising patience, demonstrating non-judgemental attitudes and remaining sensitive to the changing moods of the interviewees. The interviewers recognized the need
to balance this sensitivity with the focus and assertiveness necessary to see the interviews through to completion.
The interviewers viewed their involvement in the survey as a very positive experience. They hoped the survey would benefit other users. It deepened their own awareness of the impact of mental health problems on people's lives, and provided some insight into the effects of institutionalization. They enjoyed the challenge and responsibility of getting questionnaires completed, and the chance to meet new people and visit new places.
1. Ruggeri, M. et al. (1994) 'Acceptability, sensitivity and content validity
of the VECS and VSSS in measuring expectations and satisfaction in
psychiatric patients and their relatives' Soc Psychiatry Psychiatric
Epidemiology 29 pp. 265-76

A DIY guide to user research
Over the last eighteen months, the Mental Health Foundation's 'Strategies for Living' project has supported six local user-led research projects to investigate areas of mental health identified as important by people with experience of mental distress or of using services. This experience has been incorporated into The DIY Guide to Survivor Research.
'User-led research' means that service users get the opportunity to set or ask the questions and decide on the topic for research, as well as to design and carry it out.
Training sessions with the user-researchers covered information on different research methods, as well as, for example, group facilitation. Qualitative methods are the main focus as these are better suited to small-scale, in-depth studies. One-to-one interviews were quite popular, as were focus or discussion groups, with consideration given to the different skills involved in these. Some people felt their strengths lay more in interviewing individuals, while others were more comfortable in working on developing topic guides and report writing. The researchers were encouraged to reflect upon the experience and to write a short piece in their research reports on their own role within the project.
Some interesting issues have arisen from this work. Everybody faced issues concerning identity - both as service users/survivors and as researchers. The issue of appropriate support and supervision has arisen for some, and in some cases there were difficulties regarding ownership, accountability, and access. Each training day is written up in the DIY Guide, giving the reader the opportunity to follow each project through from beginning to - nearly - the end. The reports are due out later this year. The Mental Health Foundation 'Strategies for Living' team

The DIY Guide to Survivor Research is available from the Mental Health Foundation (£30/£15 user rate +£1.40pandp), 20-21 Cornwall Terrace,
London NW1 4QL, tel. 020 7535 7400.

The supported projects

• Surrey - giving and receiving massage in a group
• South Wales - drop-in services, looking at issues of peer support and empowerment
• Manchester - the impact of attending places of worship, and of faith generally, on the well-being of Moslem men
• London - researching how, and in what ways, being part of a local user group benefits people
• Brighton - auricular (ear) acupuncture for women with long-term mental health problems
• London - alternative local treatment choices including complementary therapies, spiritual beliefs and self-help and coping strategies
  

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