Service User Involvement in UK Social Service Agencies and Social Work Education

Forming partnerships with service users became a requirement for social work education programs in the United Kingdom as of 2003, leading to the development of innovative approaches to social work education that involve service users as experts who are helping to teach the future generation of social workers. This article examines the perceptions of service user involvement and how it is implemented in the United Kingdom in the social service sector and the university setting, and concludes with implications for the United States. ARTICLE HISTORY Accepted: May 2015 Service users have increasingly become involved in the planning and delivery of social services in the United Kingdom. A new and substantial body of literature examines service user participation in the government-run and community-based social services sector, and many scholars make the case that this involvement is necessary for social service reform (Beresford, 1994; Beresford & Croft, 1993; Webb, 2008). Indeed, it is seen as a key step in moving away from the bureaucratization of social services where the social worker becomes distanced from the service user’s perspective (Askheim, 2011; Järvinen & Mik-Meyer, 2003). Forming partnerships with service users has also become a requirement for social work education programs in the United Kingdom as of 2003, leading to the development of innovative approaches to social work education that involve service users as experts based on experience, which is valuable for the education of future social workers. This article examines the different ways service user involvement is perceived and implemented in the social service sector and the university setting in the United Kingdom. It begins with the definition of service user involvement and related legislation followed by a discussion of the impact of service user involvement. The focus then shifts to social work education in the United Kingdom and concludes with implications for the United States. Defining service user involvement Service user describes people who use, or have used, services such as mental health services or disability-related services. In the United Kingdom’s Department of Health, the terms refers to “anyone who has experienced mental distress, may or may not access mental health services and chooses to define themselves as a service user,” as well as “people with previous experiences of distress and/or services and consider themselves ‘recovered’ but who still identify with the issues experienced by those with mental distress” (Health and Social Care Advisory Service, 2005, p. 11). In the United States and Canada, terms such as consumers or clients are commonly employed in a similar context. The literature from the United Kingdom suggests that the term service user is preferred because people who “use services” are perceived as having some control over those services, similar to the relationship between consumers and businesses (Coldham, 2012, p. 4), although others dislike the term because they feel that user implies being a passive recipient of CONTACT Michael J. Austin [email protected] University of California, Berkeley, School of Social Welfare, 120 Haviland Hall, Berkeley, CA 94720. © 2017 Council on Social Work Education JOURNAL OF SOCIAL WORK EDUCATION 2017, VOL. 53, NO. 1, 37–51 http://dx.doi.org/10.1080/10437797.2016.1246271 services (Gupta & Blewett, 2008). McLaughlin (2009) explores the use of all the terms and advises us to keep searching for another term. Involvement, another term that has numerous meanings, is used to describe someone becoming active in one’s own care and in the care of others in similar situations. Some prefer participation instead, as it implies being actively and voluntarily involved (Coldham, 2012). Others argue there is a continuum of engagement, especially when service users are more extensively engaged with service providers, leading to a shift from a more passive sense of “user involvement” to a more proactive role of “user participation” (Kjellberg & French, 2010, p. 2). Some choose to distinguish between “management-centered user involvement” where service users take part in a preexisting structure using a process defined by professionals, and “user-centered user involvement,” where service users help define the organization’s objectives and priorities (Moriarty et al., 2007, p. 15). Indeed, the way service users become involved—or are asked to become involved—is a contentious area because it either becomes a mechanism to help service providers do their jobs in a more effective way within the current power structure, or it can be a truly empowering way to share power between service users and service providers. In either case, the focus of user involvement is fundamentally about involving people who use human services in the planning and decision making regarding their care and the care of others. Support for user involvement Service user involvement in the form of client self-determination and strengths-based practice are key principles of social work practice and can be attributed to a number of factors. First, service users who have increasingly voiced their criticism of the way services are delivered or of discriminatory practices have become effective at pressuring organizations to involve clients in the decisions that affect them. Second, government policies have begun to explicitly promote service user involvement, which can be linked to various scandals highlighting failings in services in the United Kingdom that were followed by citizen outrage (Coldham, 2012). Participation is also seen as a way to illustrate good intentions and responsiveness on the part of government and as a way to revitalize civic engagement and the potential to increase service user voting behaviors as well as participation in political parties (Social Care Institute for Excellence, 2007; Webb, 2008). Thus, it is a way policy makers can show their commitment to a participative democratic process (Beresford, Green, Lister, & Woodard, 1999). Some also see the importance of this movement as extending beyond the scope of social services and political involvement. For example, the notion of “nothing about us without us” has been a central theme in the international disability rights community and now also in various service user movements (Coldham, 2012, p. 7). Such movements “constitute the most important and far-reaching force for more liberatory social work and social services so far” (Beresford & Croft, 2004, p. 62). Liberatory social work is a framework that recognizes that “there must be some understanding of the links between people’s personal experiences of oppression and the structural reality of inequality” (Gupta & Blewett, 2008, p. 460). The service user movement is liberatory in that it goes beyond organizational changes and service modifications to more significant transfers of power and decision making (Beresford & Croft, 2004). Relevant legislation in the United Kingdom There have been explicit requirements for user involvement in the United Kingdom since the 1989 Children’s Act (United Kingdom Parliament, 1989) and the 1990 NHS and Community Care Act. The requirements call for involving service users in assessments, complaint procedures, service management, and planning (Beresford & Croft, 2004, p. 61). Significant legislation in the United Kingdom regarding the involvement of service users also includes the provision for making direct payments to disabled service users, as reflected in the Health and Social Care Act (2001) (Social Care Institute for Excellence, 38 C. GOOSSEN AND M. J. AUSTIN