An analysis of the transcripts of all the interviews undertaken with service users, carers and professionals uncovered 3 major themes, each in turn containing 3 sub themes:
Involves the importance of creating opportunities for services users, carers and professionals to learn from each other. In addition the challenges around appropriately and constructively sharing information (inc. confidentiality) are also key. Learning together to develop an understanding of the risks and opportunities on the recovery journey allows for a recognition that professionals wouldn’t always get it right.
‘I like them (professionals) to be straight talking and very honest and open and I don’t like things being done behind like closed doors or without my knowledge and they’re aware of that, so they’re very straight with me, whether I like it or I don’t like it, at the time, I’ll always go away and think about it’ (Service User 140).
Peer support was repeatedly indicated as a strong means to move people reported as ‘stuck’ in services forward. Taking responsibility and moving on leaving dependency behind are key to recovery. For this to take place all concerned may need to step out of their comfort zones and take supported, positive risks. Levels of personal responsibility need to be discussed, negotiated and mutually agreed in response to risk.
‘You’re responsible for yourself and we’re responsible for helping you to make the best of your life and overcome your problems. I think we are far too quick to take responsibility away from service users. I can’t see how recovery can happen without them taking it back…’ (Professional 8).
The challenge to care coordination is to move further away from being seen as an important but rather bureaucratic process to more of a supportive relationship. This is particularly key around times of crisis if people are to move on with their lives and be less reliant on services. When what service users regard as effective professional listening takes place, it makes a positive difference to how people feel about care coordination. When it doesn’t work well service users feel that they are merely a tick box and not valued:
‘if she [CPN] could see a problem with my wife she would there and then phone the doctors; ‘I want an appointment’…or am I going to do this or that. That was great but now people just seem to be if you don’t mind me saying ticking boxes.’ (Carer 9).