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Service user perspectives of community mental health services for people with complex emotional needs: a co-produced qualitative interview study

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Kylee Trevillion, Ruth Stuart, Josephine Ocloo, Eva Broeckelmann, Stephen Jeffreys, Tamar Jeynes, Dawn Allen, Jo Billings, Mike Crawford, Dale Oliver, Jessica Russell, Rex Haigh, Paul Moran, Shirley McNicholas, Vicky Nicholls, Una Foye, Alan Simpson, Brynmor Lloyd-Evans, Sonia Johnson, Sian Oram

Original languageEnglish
Article number55
JournalBMC Psychiatry
Accepted/In press9 Nov 2021


King's Authors


There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users’ views and co-production initiatives have had little impact on the development of interventions and care. This needs to change, and our paper evidences the experiences and perspectives of a diverse range of people on how community services can best address the needs of people with complex emotional needs.

A co-produced qualitative research study. Lived experience researchers led data collection and analysis. Individual interviews were conducted with 30 people across England who had a diverse range of experiences and perspectives of using community services for complex emotional needs. Participants were asked about their experiences of using community services for their mental health, and views on how community services can best address their needs. Thematic analysis was used to analyse the data.

Participants reported some experiences of good practice but also of experiences of severely stigmatising interventions, a lack of effective support and service fragmentation. Relational Practice was identified as the central overarching theme and describes how community services can best support people with complex emotional needs. This approach involves care delivered in a non-stigmatising, individualised and compassionate way and care that is trauma-informed. It involves care that is planned collaboratively with service users to ensure their multiple needs are addressed in a flexible, holistic and consistent way which accounts for the long-term and fluctuating nature of their needs.

Relational practice approaches have potential to facilitate better community care for people with complex emotional needs. Research and service development are needed to examine how best to implement such approaches across the mental health service system. This work must be co-produced with people with relevant lived experience, their carers and the professionals who support them.

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