Background: There are a number of models of patient and carer participation. Their usefulness and applicability to old age psychiatry is considered.
Methods: Models of participation are reviewed and related to examples of participation initiatives drawn from the author's work in the context of the National Health Service in the United Kingdom.
Results: Models of participation which emphasize collaboration and partnership are found to be useful. Simple interventions such as copying letters to patients and/or carers can lead to change in the balance of power between staff and patients/carers. Initiatives which draw on the experiences of patients and carers can facilitate organizational learning and development. Involving patients and carers in education offers a way to influence services and the staff working in them.
Conclusion: Participation is better understood as a spectrum rather than a hierarchy. Old age psychiatry services would benefit from developing greater patient and carer participation at all levels.
