The use of clients' experiential knowledge in mental health care
The use of clients' experiential knowledge in mental health institutions requires adjustments in organization and regulation as well as professional attitudes and actions. This is what Aukje Leemeijer concludes in her dissertation Het zit gewoon niet goed in mijn systeem (It's just not in my system). She observed three treatment teams in mental health and analyzed how professionals cooperate with experiential experts, if and how they use the experiential knowledge of this relatively new professional group in the care and service to clients.
Leemeijer observes that professionals often strive for space for clients' own direction and perspective as well as space for their professional action. They indicate that experiential expertise can contribute to this. However, large mental health care institutions in which these professionals work contain barriers for offering such space. Existing regulations are one of these barriers, e.g., linked to budget allocation and accountability. In the teams studied, this leads to substantial performance and accountability pressures, as well as tendencies to control and risk aversion. In addition, implicit ideas about knowledge and professional actions play a role.
Aukje Leemeijer is researcher and consultant at the University of Applied Science Arnhem / Nijmegen (HAN) and was a PhD student at the Utrecht University School of Governance (USG). On Wednesday 28 February she defended her PhD thesis It’s just not in my system. Etnographic research into the use of clients’ experiential knowledge in mental health institutional practices successfully.
Organising the use of experiential knowledge
Healthcare professionals are required to work according to scientifically based guidelines. This leads to doubts about the value of experiential knowledge, which is based on individual experiences. Is it 'real', generally valid knowledge? Following on from this, professionals and experiential experts themselves struggle with their role: are they professionals, or primarily ‘fellow sufferers’?
Strengthening experiential expertise in professional services requires change on several fronts. Leemeijer outlines three routes for this: further professionalization of experts by experience, opting instead for voluntary commitment, or looking for the best form for each context and situation.
Some recommendations recur in each route:
- More flexibility in regulations, so that performance and accountability pressures are reduced and control and risk aversion are less dominant.
- Time for teams and professionals to discuss mutual expectations and beliefs.
- Training and education of professionals who can work together and bridge the boundaries between different types of knowledge and perspectives.
Strengthening experiential expertise implies jointly organizing experiential expertise.
More information
Would you like to have more information? Please reach out to press officer Gert den Toom (g.dentoom@uu.nl). He can bring you into contact with the researcher, Aukje Leemeijer.
You can listen to the podcast 'Changemakers' of the University of Applied Sciences Arnhem and Nijmegen, where she spoke about her research (in Dutch).
Or read the full PhD thesis Het zit gewoon niet goed in mijn systeem (also in Dutch).