Towards an Integrative Perspective of the Actively Involved Person in Mental Health Care: A Concept Mapping Approach.

OBJECTIVE: The importance of being actively involved in dealing with mental health care problems is well-recognized. Many terms and ideas have been introduced to explicate this active involvement, but to date, there is no consensus about a definition. This study aims to create an integrative perspective that brings together different ideas about the actively involved user in mental health care. METHOD: Following a concept mapping procedure, we collected the statements of stakeholders involved with mental health care about this active involvement during two brainstorm sessions (total N = 12). These stakeholders included clinicians, researchers, policy makers, and users of mental health care. A larger group with the same characteristics but that also included people otherwise concerned with mental health care (N = 25) sorted and rated the statements based on perceived similarity and importance. RESULTS: The result was a concept map with six clusters: adjustment, participation, agency, networking, self-determination, and resilience. Most clusters were deemed to be equally relevant. The spatial configuration of the clusters suggested two underlying dimensions captured by focus (changing-strengthening) and locus (self-context), which together formed four quadrants representing distinct expressions of active involvement. CONCLUSIONS: The dimensional and quadrants integrate the literature surrounding active client participation into a coherent framework and give rise to a dynamic interpretation of active involvement in which individuals gradually regain ownership over their mental health state. In doing so, this conceptualization offers a framework for understanding the different ways in how active client participation can be expressed and supported throughout treatment.