— Case studies / Research

What the paper adds to existing knowledge: An exploration of EBE involvement in nursing education from the perspective of those with lived experience. The development of standards designed to provide structure to better support future EBEs involved in higher education. An exemplar for co-production of standards between EBE and nurse academics which has applicability for other contexts.

What are the implications for practice?: The standards could potentially strengthen EBE involvement in mental health nursing education, enhance their confidence and increase the retention of EBEs by creating an inclusive working culture. By increasing support for EBEs, the benefits to mental health nursing practice are likely to be maximized.

Introduction: Involving people with lived experience of mental distress in mental health nursing education has gained considerable traction yet broader implementation remains ad hoc and tokenistic. Effective involvement requires curricula be informed by lived experience of service use. Aim To develop standards to underpin expert by experience involvement in mental health nursing education based on lived experience of service use.

Methods: Phase one used qualitative descriptive methods, involving focus groups with service users (n = 50) from six countries to explore perceptions of service user involvement in mental health nursing education. Phase two utilized these findings through consensus building to co-produce standards to support Experts by Experience involvement in mental health nursing education.

Results: Three themes emerged in Phase one: enablers and barriers, practical and informational support, and emotional and appraisal support. These themes underpinned development of the standards, which reflect nine processes: induction and orientation, external supervision, supportive teamwork, preparation for teaching and assessing, "intervision," mutual mentorship, pre- and post-debriefing, role clarity and equitable payment.

Conclusions: These standards form the framework entitled; Standards for Co-production of Education (Mental Health Nursing) (SCo-PE [MHN]). Implications for Practice The standards aim to support implementation of Expert by Experience roles in mental health nursing education.

Their aim in the services is to bring in the perspective of service users in interactive processes at the micro and macro levels. The services´ ability to exploit the knowledge from PSW´s lived experiences will influence both the content and quality of the services, its effectiveness and its capacity to innovate and change. The concepts of co-production and co-creation are used to describe these interactive processes in the services in the literature. While co-production is aimed at improving individual services, co-creation seeks to develop service systems. This scoping review aims to provide an overview of the research status of PSW´s different involvement, in co-production and co-creation, in public mental health and addiction services. Studies describing PSW´s involvement in co-production and co-creation will be contrasted and compared. Knowledge about PSW´s involvement in co-production and co-creation is vital for understanding and further developing these interactive processes with PSW´s. The studies reviewed will describe PSW´s different types of involvement in co-production and co-creation in public mental health and addiction services or across organizational and institutional boundaries. The research question is: How are peer support workers involved in co-production and co-creation in public mental health and addiction services, and what are the described outcomes? Literature searches are conducted in Medline, PsycINFO, Embase, Oria, WorldCat, Google Scholar, Scopus, Academic Search Elite, Cinahl, and Web of Science, from the inception of each database to January 4, 2021. Expected results are that PSW´s are often described as a frontline worker who spends most of their working hours in a joint effort to co-produce with service users. Fewer studies describe PSW´s involved in interactive processes to re-design or transform public services systems. It is anticipated that this scoping review will increase the knowledge of the services’ abilities to exploit PSW´s expertise and inform policy and research

The results of the interviews were divided into two categories (Position Specifics, Ethical Aspects) and four subcategories (Professionalism, Risk Moments, Stigmatization, Shared Values) using the Coding Method. The individual subcategories were further subdivided in detail. The results show that the most negative influence on the successful involvement of peer workers is the unclear definition of the job role and responsibilities and further, from an ethical point of view, it is the fear of subsequent labelling (stigmatization) in the search for a new job. A positive ethical influence is the sharing of social values (hope, recovery, friendship, sharing, etc.), which supports the peer worker. The study could help anchor the role in practice and could be the basis for further research in human resources management, social work and management.

Method: A grounded theory study interviews were conducted with 13 lived experience practitioners.

Results: The medical model was a core category arising from this work. Participants described the medical model as a prevailing culture within mental health services from their personal and professional experiences. This culture imposed a major limitation on the implementation, effectiveness and development of lived experience roles and themselves as individuals. It was also seen as a major limitation to the progress of Recovery orientated reform.

Conclusions: The development of Recovery oriented services requires a strong lived experience practitioner workforce, with appropriate resourcing and support available. The current medical model approach requires critique to facilitate reform and avoid tokenism.

Keywords: Consumers; lived experience practitioners; medical model; mental health services