Thesis

Coproduction in high and medium security mental health settings

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Awarding institution
  • University of Strathclyde
Date of award
  • 2026
Thesis identifier
  • T17623
Person Identifier (Local)
  • 201372329
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Qualification Name
Department, School or Faculty
Abstract
  • This study aimed to understand how rules-based environments in secure mental health care across Scotland and Ireland affect forms of coproduction and how staff conceptualise this process. The research was required because existing coproduction studies have predominantly focused on community settings, leaving a critical knowledge gap about collaborative partnerships within secure care environments where safety and security concerns limit traditional approaches. Using thematic analysis of 28 interviews and three focus groups with 33 staff across high, medium, and low-security facilities, the research reveals that coproduction exists along a developmental continuum from compliance through cooperation to authentic coproduction, characterised by trust, reciprocity, and autonomy. The study demonstrates how environmental conditions, staff orientation, cognitive biases, and institutional cultures significantly influence coproduction potential, with off-ward spaces affording greater relational engagement opportunities than high-stimulus ward environments. By applying game theory to staff-patient interactions, the research illuminates how repeated interactions foster cooperation despite power imbalances, creating Nash equilibria where maintaining peace benefits both parties. The findings suggest that seemingly inconsequential daily interactions represent legitimate expressions of coproduction overlooked by previous definitions, expanding classical conceptualisations beyond service design to include relational processes that contribute to shared outcomes. The study offers practical recommendations including rotating staff between ward and off-ward positions, addressing team dynamics that reinforce custodial cultures, and implementing dynamic risk assessments that meaningfully involve patients. Whilst acknowledging limitations, particularly the absence of patient perspectives, this research provides nuanced understanding of how coproduction manifests within security constraints, offering insights for theory, research, and practice development in secure care environments and broader coproduction applications.
Advisor / supervisor
  • MacIntyre, Gillian
Resource Type
DOI
Date Created
  • 2025

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