Collaboration with clinicians in inpatient mental healthcare: a qualitative investigation of consumer perspectives

Collaboration is a foundational characteristic of ethical mental healthcare. However, inpatient mental healthcare often fails to espouse the practices and principles that would establish meaningful collaborative care, with coercion and restrictive practices an ongoing aspect of consumers' lived experience. This qualitative descriptive study aimed to understand consumers' perspectives of collaboration with clinicians in the inpatient mental health setting. One-on-one semi-structured interviews were conducted with 12 people who have experienced involuntary inpatient mental healthcare; data were analysed by thematic analysis. The participants of this study valued collaborative inpatient mental healthcare. However, they reported that their own perspectives were not sufficiently sought or considered. Clinicians' default scepticism compounded participants' experiences of inconsideration. In contrast, genuinely caring interpersonal relationships with clinicians were valued, establishing a sense of safety and collaboration. The failure to establish collaboration requires systemic reform and the resolution of micro-cultures that disenfranchise the perspectives of people receiving inpatient mental healthcare. Notably, the participants of this study reported that interpersonal relationships with clinicians facilitated meaningful collaboration. Collaboration relies on the presence of strong interpersonal care; the culture, policy and structures of inpatient mental healthcare must be oriented to be interpersonal.