Experiential knowledge in mental health services - experiences of individuals with mental health problems and service providers in primary and specialist healthcare

Background: The prevalence of mental health problems is increasing, placing growing pressure on mental healthservices to provide care that is meaningful, accessible, and supportive for those who require it. However, currentpractices often do not fully meet individuals’ needs for person-centred, recovery-oriented, and integrated care andsupport. As these care and support models are being introduced, it is essential to first explore the experientialknowledge of current practices, those who use services and those who provide them. Such experiential knowledge isvital for informing future initiatives and ensuring that service development is grounded in scientific evidence,relevance, and experience-based knowledge.Aims: To explore the experiential knowledge of individuals who require care and support for their mental healthproblems, as well as of the mental health service providers who deliver such care and support within Swedish primaryand specialist mental health services.Methods: A thematic synthesis was conducted to address the overall aim and was based on the results of fourqualitative methodologies, each applied to meet the specific aim of its respective study. Study I employed descriptivephenomenology and Study II a constructivist grounded theory these were situated within the context of primaryservices. Study III applied a reflexive thematic analysis and Study IV employed a content analysis, both conductedwithin the context of specialist services.Results. The thematic synthesis emerged in one overarching theme: ‘The need to strengthen the culture andstructures of services to address human vulnerability’ grounded in three themes, Vulnerability as not being seen orhaving influence, Current organisational structures can constrain the conditions for delivering meaningful care andsupport and Strengthening a culture of safety and belonging through practical collaboration. The results for eachstudy-specific aim are presented in the respective study.Conclusion The experiential knowledge of primary and specialist services reveals and highlights that anunderstanding of human vulnerability, as experienced by both individuals in need of care and support for their mentalhealth problems, and by the mental health service providers themselves, is central to the provision of meaningfulmental health care and support. Thus, strengthening the structures and culture of services requires not onlyorganisational reform, but also relational and moral awareness among all actors involved.