Description and evaluation of a serious game intervention to engage low secure service users with serious mental illness in the design and refurbishment of their environment

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  Providers of mental health services are expected to engage service users in all aspects of planning and delivery of care. In practice, however, service user engagement is often tokenistic, involving post hoc consultation over plans already committed to by services. The challenge for service user engagement lies in the difficulty that service users, a traditionally marginalized and powerless population, have with engaging powerful mental health, design and construction professionals in meaningful discourse. This is compounded further by service users’ lack of experience in the recognition and articulation of their needs.
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  The use of serious games as a novel way to engage service users has gained some currency in mental health services. Its advantages lie in the familiarity of its format, its non-threatening facilitation of communication and its creative and fun approach to serious issues.
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  This paper describes the use of the serious game format to engage low secure service users in insightful discussions about the design and refurbishment of their service. It was used to answer particular design and refurbishment questions where traditional methods of engagement such as community meetings and one to ones had not been productive in answering or even in initiating the most cursory of interest
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  The use of the serious game format has potential for mental heath services to successfully engage service users in collaborative dialogue that they have previously been excluded from or which they have been unwilling to engage in, such as treatment planning, illness education and recovery.

Service user involvement in all levels of healthcare provision is the expectation of UK government policy. Involvement should not only include participation in the planning and delivery of health care but also the exercise of choice and opinions about that care. In practice, however, service user engagement is most often tokenistic, involving post hoc consultation over plans already committed to by services. This paper explores an Occupational Therapy-led initiative to use the Serious Game format to engage low secure service users with serious mental illness in the design, layout and refurbishment of their unit. Among other things how medication was to be dispensed on the new unit was explored by this game and led to significant replanning in response to service user involvement. The game format was found to be a useful tool in facilitating communication between professionals and a traditionally marginalized and powerless client group. It enabled service users to have a voice, it provided a format for that voice to be heard and made possible service-led change in the planning process.