# Turning to Service Users for the Understanding of Current and Future Mental Health Services in the Development Process of Research and Practice: A Qualitative Study

**Authors:** Emmy Nilsson, Carina Tjörnstrand, Daniel Lindqvist, Jenny Wetterling, Annika Lexén, Ulrika Bejerholm

PMC · DOI: 10.1111/hex.70574 · Health Expectations : An International Journal of Public Participation in Health Care and Health Policy · 2026-01-24

## TL;DR

This study explores how involving mental health service users in care design can improve future services by focusing on their experiences and needs.

## Contribution

The study highlights the importance of integrating service users' experiential knowledge into the development of recovery-oriented mental health care models.

## Key findings

- Service users often feel reduced to their symptoms, losing personal value in current mental health systems.
- Participants emphasized the need for greater involvement in their care to feel empowered and supported.
- Structural issues like hierarchy and financial constraints must be addressed before implementing new care models like FACT.

## Abstract

A person‐centred and recovery‐oriented approach is an integral part of modern mental health services founded on the experiential knowledge of service users. Their reflections as experts, grounded in their unique experience as service users, play a significant role in developing and improving the existing care. Experiential knowledge is therefore a means to enhance the relevance of research, inform the development of care, and bridge research and practice.

To understand service users' experiences of their current mental health services and explore reflections on the Flexible Assertive Community Treatment (FACT) model and its role in future practice.

A total of 17 experts participated in individual and dyadic in‐depth interviews. A reflexive thematic analysis was performed on the participants' experiences of current mental health services and on their reflections on a vignette describing an integrative, recovery‐oriented care and support model—FACT.

The analysis resulted in three themes. The first theme, ‘Losing value and credibility as a person when becoming a service user’, reflected participants' experiences of being reduced to the signs and symptoms of their mental health problems. The second theme, ‘Navigating through the mental health maze’, describes participants view on the current mental health services, while the last theme, ‘Involving service users in their care and support would be empowering’, holds participants' views on the importance of greater involvement in future service design and delivery.

These results underscore the necessity for enhanced collaboration to empower and provide inclusive, tailored care and support, which the participants emphasised as essential for the future of mental health services. The participants reflected on certain structural concepts, such as hierarchy, caring culture, and financial strains, prior to the implementation of FACT, which need to be addressed before an adaptation of integrative, recovery‐oriented care and support models.

The study planning and process involved stakeholders, including user organisations, Swedish Partnership for Mental Health (NSPH), Skåne and their sister organisation LIBRA Skåne, as well as managers and professionals of mental health services. One of the authors has own experience of mental illness and contributed greatly to the data analysis and the finalising of the manuscript, and two authors have experience as relatives.

## Full-text entities

- **Diseases:** MHP (MESH:D000076082), hypomanic (MESH:D001714), depression (MESH:D003866), COVID-19 (MESH:D000086382), illness (MESH:D002908), psychosis (MESH:D011618), FACT (MESH:D003147), mental disease (MESH:D008607), MHS (OMIM:603663), mental illness (MESH:D001523), addiction (MESH:D019966)
- **Chemicals:** FACT (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

86 references — full list in the complete paper: https://tomesphere.com/paper/PMC12831172/full.md

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Source: https://tomesphere.com/paper/PMC12831172