(The Lancet Psychiatry) – “If psychiatry is to remain relevant and achieve the ambitions for psychiatrists to ‘stand up for the rights, dignity, and inclusion of people with mental disorders’, then psychiatrists must recognise that service user experiential and first-hand knowledge is legitimate.”
This response to last year’s WPA-Lancet Psychiatry Commission on the Future of Psychiatry set out a challenge not just for clinical and research professionals, but also for mental health journals. How can they ensure that those with the biggest stake in decisions made over the future of psychiatry—people with personal experience of mental health problems—are a substantial, indeed a leading, part of the drive towards better care?
One solution is through including people with direct experience of the mental health system in the peer review process. Peer review has many functions: it provides the editors with important information about a study’s robustness and relevance to the field, and the authors with fresh perspectives on work that might have been in process for many years.
For reviewers, it offers an opportunity to see and comment on new findings and influence what is published and what is not. For readers, who are often busy health professionals or patients searching for information, peer review provides the reassurance of an initial check that a paper’s message and methods are worth their attention.
Over time, for everyone involved in the process, it builds a community of common interest around specific topics. Peer review is only one approach to publishing, and it is not without its critics, but even those who point out its flaws have concluded that the most important question “is not whether to abandon it, but how to improve it”.
It seems to us that one way to improve peer review is to empower all relevant stakeholders to contribute their expertise within the peer review process. This initiative is not just a matter of enhancing quality: it is the right thing to do to produce more relevant and useful research that can actively contribute to better and more effective mental health services.
The Lancet Psychiatry is therefore working with the McPin Foundation (London, UK) in launching a process for peer review of Articles by people with direct experience of using mental health services. McPin is a specialist research charity that champions the integration of expertise from experience in all aspects of the research process, including leading research studies and prioritising what research should be funded. Through this new partnership, it seeks to develop the role of the lay reviewer, first in a small way with ten people from the UK, but with bigger ambitions to extend the scheme worldwide.
This idea is not new, other medical journals have patient reviewers, and mental health services include service users within peer review teams as part of quality assurance schemes. Nor is it particularly straightforward. How do you select ten people to cover the entire scope of mental health? How will service user reviews be used in the decision-making process? We have chosen the term lay reviewers to emphasise the importance of direct experiences gained from having been in receipt of mental health services within the review process.
Our initial programme will consist of recruiting a diverse panel of ten interested people who have used mental health services in the UK to review randomised controlled trials and systematic reviews. These individuals will receive training in peer review in London, UK, and online from The Lancet Psychiatry editorial team supported by McPin staff. Travel costs for an annual meeting will be funded by the McPin Foundation, and The Lancet Psychiatry will offer reviewers payment for their work. The McPin Foundation is not receiving any payment from The Lancet Psychiatry or its publisher.
The programme will be open to applications until Oct 19, 2018, and we aim to have our service user review panel in place by the end of January, 2019. We will review the programme after 1 year; we anticipate that the system will change and develop, and are committed to learning from its successes and challenges. The Lancet Psychiatry and the McPin Foundation hope that this collaboration contributes to the development of mental health research publishing and further understanding the value of experiential knowledge in the research process.
For more details of the programme see www.mcpin.org
For more on the peer review process see https://www.elsevier.com/en-gb/reviewers/what-is-peer-review