Background Involvement of service-users at all levels of the mental health system is a policy imperative in many countries internationally. However, putting policy into practice seems complex; little is known about how best to involve service users and efforts are often criticized for being tokenistic. In low-and-middle income countries, less attention has been given to the roles of service users within mental health systems. The proposed study is part of a larger project intended to develop service-user involvement in mental health system strengthening in Ethiopia. A Theory of Change (ToC) model has already been developed through a participatory approach. This study protocol aims to describe the theoretical background and methods to pilot this model using participatory action research (PAR) and explore participants' experience of involvement. Methods The proposed study will apply a PAR approach situated in critical social theory and conduct a phenomenological case study to find out participants' experience of involvement. This will be conducted in three stages. The focus of Stage 1 will be to(i) establish a Research Advisory Group (RAG), and Research Participant Group (RPG) at district and primary healthcare facility levels, respectively, and (ii) identify and prioritize potential areas of concern for involvement in the domains of advocacy, service planning and development, monitoring and improving service quality. In Stage 2, we will work with the RPG to develop a plan of action for the selected area. Stage 3 will aim to assist the RPG to implement and evaluate the plan of action. Process indicators and observation will be combined with in-depth interviews with participants to elicit their experiences of involvement. Thematic content analysis will be used. Discussion The participatory approach to mental health service user involvement in health system strengthening employed by this study will support the implementation of solutions through locally relevant and contextualized actions. Findings from this study will contribute to the body of knowledge towards understanding the complexity of implementation of service user involvement and refine the ToC model for transferability to similar settings.

中文翻译：

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在埃塞俄比亚农村初级卫生保健环境中试点心理健康服务用户参与模型的参与性行动研究：研究方案。

背景 在国际上许多国家，服务使用者参与各级精神卫生系统是一项势在必行的政策。然而，将政策付诸实践似乎很复杂；人们对如何最好地让服务用户参与进来知之甚少，而且这些努力常常被批评为象征性的。在中低收入国家，人们很少关注服务使用者在精神卫生系统中的作用。拟议的研究是一个更大项目的一部分，该项目旨在促进服务使用者参与加强埃塞俄比亚的精神卫生系统。变革理论 (ToC) 模型已经通过参与式方法开发出来。本研究方案旨在描述利用参与式行动研究（PAR）试点该模型的理论背景和方法，并探索参与者的参与体验。方法 本研究将应用批判社会理论中的 PAR 方法，并进行现象学案例研究，以了解参与者的参与体验。这将分三个阶段进行。第一阶段的重点是（i）分别在地区和初级医疗机构层面建立研究咨询小组（RAG）和研究参与者小组（RPG），以及（ii）确定并优先考虑参与的潜在关注领域在宣传、服务规划和开发、监测和提高服务质量等领域。在第二阶段，我们将与 RPG 合作，为所选区域制定行动计划。第三阶段旨在协助 RPG 实施和评估行动计划。过程指标和观察将与参与者的深入访谈相结合，以获取他们的参与经验。将使用主题内容分析。讨论 本研究采用的精神卫生服务使用者参与卫生系统强化的参与式方法将支持通过当地相关和情境化行动实施解决方案。这项研究的结果将有助于了解服务用户参与实施的复杂性，并完善 ToC 模型以实现类似设置的可转移性。