User involvement in the handover between mental health hospitals and community mental health: A critical discourse analysis

Introduction: This study aimed to explore how healthcare professionals and users could perceive user involvement in the handover between mental health hospitals and community mental healthcare, drawing on the discourse analysis framework from Fairclough. Methods: A qualitative research design with purposive sampling was adopted. Five audio-recorded focus group interviews with nurses, users and other health professionals were explored using Fairclough’s discourse analysis framework. Ethical approval: The study was designed following the ethical principles of the Helsinki Declaration and Danish Law. Each study participant in the two intersectoral sectors gave their informed consent after verbal and written information was provided. Results: This study has shown how users can be subject to paternalistic control despite the official aims that user involvement should be an integral part of the care and treatment offered. As evidenced in discussions by both health professionals and the users themselves, the users were involved in plans with the handover on conditions determined by the health professionals who were predominantly focused on treating diseases and enabling the users to live a life independent of professional help. Conclusions: Our results can contribute to dealing with the challenges of incorporating user involvement as an ideology in the handover between mental health hospitals and community mental health. There is a need to start forming a common language across sectors and, jointly, for professionals and users to draw up plans for intersectoral care.