Marginalised groups and health services: provision, experiences and research issues

This commentary is a reflective account of research published over the last eleven years. It highlights the themes underlying the publications and tracks the development of the author's research skills while simultaneously showing the impact of the publications on knowledge in the areas covered. Three themes from the research are highlighted. The first relates to the research participants in the publications who include detained and voluntary psychiatric patients, minority ethnic groups and carers. Members of these groups can all be described as marginalised or disadvantaged and are known to sometimes have poorer experiences of health and health services. Their experiences are the second theme. The commentary then highlights some issues in the research as the third theme, in particular the often unrecognised impact of the methods used and concepts employed on the research findings. Although some limitations of these are described, the commentary demonstrates the complexity of the concepts and issues and suggests that these should be acknowledged more widely. A possible way forward is by greater involvement of service users and altering the research perspectives. The next section discusses the impact of being a contract researcher during a period of greater recognition of the importance of listening to patients and their carers. This has had a bearing on both the research and the author's development as a researcher. The commentary then provides reflections on the individual publications submitted detailing the roles played by the author and recent research in the area. Some overarching ethical issues are also discussed. The ultimate aim of all the research presented here has been to improve the experiences of health service users and it is concluded that in each case it has contributed, even if only in a small way, to this aim whether to the academic literature or more directly to service improvement.