Providing purpose and motivation
depression, ill
The majority of participants reported that goal planning provided a purpose for getting together and participating in the intervention. Goals were seen to give the intervention a structured approach, providing a focus for conversations. Some service users enjoyed the challenge of doing something new, while others described additional benefits that goal planning provided in establishing routines and distractions in their lives.I think when managing mental health, having goals gives me something else to focus on instead of always worrying about all the things I have to manage with my illness and all these appointments I'm always at. And it helps me focus on something else as well. Which is a good thing. (SU12)Several service user participants identified that participating in goal planning allowed them to reflect on their personal strengths and limitations, highlighting their priorities and plans for the future. In addition, working with the pharmacists to plan goals provided ‘a sense of clarity’ (SU7) and supported service users to attend to issues that had been ‘put off’ or placed in the ‘too hard basket’ (SU24).It was because it made me stop and think that I had some goals, really. Before that, I really didn't think I had any goals. Like I didn't really speak them out in my mind, but it made me speak them out. It shone a light on what I should be doing. (SU5)All service user participants identified the role that goal planning provided in motivating them to make changes to achieve their intended outcomes. Participants articulated that goal planning held them accountable for making changes, as they tried not to disappoint anyone. Regular reviews allowed them to track their progress, and several service users reported the importance of documenting goals on paper or on their phones to support motivation and tracking.… knowing that you were going to be reporting to somebody in a couple of weeks made you sort of keep track of things better where I think at the moment I've got a tendency to let things lapse until I'm feeling a bit better. And feeling a bit better doesn't always happen. (SU24)Service user motivation levels, past experiences of goal planning and confidence were articulated as impacting readiness to participate in goal planning discussions. Some service users reported that goal planning was initially daunting and felt uncomfortable committing to their goals. However, most stated that it became easier as the programme progressed, with routines becoming established and results from their efforts apparent.At first, it seemed a bit tough … seemed like an impossible thing. And the losing weight, well as soon as I started the program, now I've lost like six and a half, seven kilos. As I got into it more, it just got easier and easier. Now, it's just a daily routine I have. (SU19)Pharmacists noted that several service users had difficulty with goal planning due to the impacts of their mental illnesses and co‐occurring health conditions. Service users described barriers that impacted their experience of planning and achieving their goals. These included episodes of ill health, changes in personal circumstances, and COVID‐19 lockdowns affecting their routines, relationships and access to community and health supports. For example, some found the process overwhelming, as they were focused on ‘just living day‐to‐day’ (P13), managing appointments and coping with symptoms. Others, particularly those experiencing symptoms of depression, struggled to think aspirationally or ‘come up with anything that they would want’ (P4). However, positive encouragement and focusing on small achievements supported service users in maintaining their motivation.[Goal planning] sets accountability, and it gives people a sense of accomplishment in what they're doing, so they do feel good once they've done it, and they find it very rewarding. (P13)