"Coming from a different place": Partnerships between consumers and health services for system change.

AIMS AND OBJECTIVES: The aim of the current study is to explore whether and how the expectations of consumers to be "representative" influences consumers' ability to contribute to health services partnerships.

BACKGROUND: Health standards call for services to partner with consumers in service development and governance. While existing research criticises the assumption that individual mental health consumers working with mental health services must be representative of consumers more broadly, research has yet to explore whether this requirement exists for consumers of other health services. Requiring individual consumers to be representative of consumers more broadly marginalises and limits consumer involvement.

DESIGN: A qualitative, exploratory design was employed.

METHODS: Consumers (n = 6), clinicians (n = 7) and health managers (n = 5) were interviewed about consumer participation in health services. Data analysis was conducted through the lens of social exchange theory and informed by discursive psychological principles.

RESULTS: The current study extends the existing literature within mental health, finding that consumers of other health services are also held responsible for representing broader communities. Data also suggested that a requirement to be representative would marginalise consumers with a passion to bring about change in health systems.

CONCLUSIONS: The findings suggest that organisations might need a culture change so that individual consumers are not expected to be representative of consumers more broadly and that participation be made more accessible for diverse groups of consumers.

RELEVANCE TO CLINICAL PRACTICE: Given the role that nurses might play as allies to consumers within health services, the findings of this study contribute to knowledge about the expectations placed on consumers and the ways that nurses might advocate for better partnerships.