Abstract
The move towards service user and carer involvement in training is set in the context of healthcare policies that emphasise the importance of user concerns. The National strategy cites 'Working in Partnership' with service users and carers, as the first of the Ten Essential Shared Capabilities for all mei:ital health workers (Hope, 2004). Department of Health Guidelines 1999 (as cited in Curle & Mitchell, 2004) state that not only should the value of service users in teaching now be emphasised in all professional training, but service users should also be involved in curriculum design and assessment.The translation of these policies into educational practice is not so well documented and the Doctorate in Clinical Psychology course at Surrey is beginning to consider ways in which policy may become a reality. I chose to explore the development of service user and carer involvement at Surrey because it is a current issue that affects everyone within the health service and training programmes. I have learnt, through my experiences as a first year trainee that often therapeutic work aims to help service users regain control over their lives that may have become chaotic due to mental distress (Barnes & Wistow, 1994). Input from service users and carers into the way that healthcare professionals treat mental distress may, therefore, not only improve the services for future users and for ourselves ( as providers and potential users), but may also serve to empower those who have used or currently use mental health services. Although I recognise that service user and carer experiences may differ, for the purpose of this discussion a clear distinction between service user and carer involvement has not been made. Tew et al. (2004) argue that overall many service users and carers would say they have more issues in common than different and most are willing to work collaboratively as long as their differences are understood. The first part of this discussion will focus on ways that service users and carers can become more involved throughout the Surrey curriculum. Examples from the literature will be used to explore how this can be achieved, starting with classroom involvement. It will then progress to consider ways in which involvement can be included in curriculum design, placement, research, assessment and selection of trainees. I will outline my understanding of how far Surrey already incorporates user involvement in these areas. The issues that involvement may create, specific to these aspects of the course, will also be discussed.The second part of this discussion will focus on three of the key issues that underlie user and carer involvement in general. These have been identified in the literature as potential barriers to involvement in many settings. They include a fear that involvement will become tokenistic, worries that those involved will not be representative of service users and carers as a whole, and the potential challenges that involvement may pose to providers' current knowledge and ways of working. Suggestions about how they might be resolved will be discussed.