scholarly journals Exploring Working Relationships in Mental Health Care via an E-Recovery Portal: Qualitative Study on the Experiences of Service Users and Health Providers

2017 ◽  
Vol 4 (4) ◽  
pp. e54 ◽  
Author(s):  
Monica Strand ◽  
Deede Gammon ◽  
Lillian Sofie Eng ◽  
Cornelia Ruland
Keyword(s):  
Mental Health ◽  
Service User ◽  
Common Ground ◽  
Working Relationships ◽  
Main Theme ◽  
Service Users ◽  
Health Providers ◽  
Care Needs ◽  
Term Care

Background The quality of working relationships between service users and health providers is fundamental in the processes of recovery in mental health. How Internet-based interventions will influence these relationships for persons with long-term care needs, and the measures that can be taken to maintain and enhance working relationships through Internet, is still not well understood. Objective The aim of this study was to gain insights into how service users and health providers experience their working relationships when they are offered the option of supplementing ongoing collaboration with an e-recovery portal. Methods In this exploratory and descriptive study, an e-recovery portal was used by service users and their health providers in 2 mental health communities in Norway for at least 6 months and at most 12 months (2015-2016). The portal consists of secure messaging, a peer support forum, and a toolbox of resources for working with life domains including status, goals and activities, network map, crisis plan, and exercises. The portal was owned and managed by the service user while health providers could remotely access parts of the service user–generated content. The participants could use the portal in whatever way they wished, to suit their collaboration. Data from 6 focus groups, 17 individual interviews, and an interview with 1 dyad about their experiences of use of the portal over the study period were inductively coded and thematically analyzed. Results The thematic analysis resulted in 2 main themes: (1) new relational avenues and (2) out of alignment, illustrated by 8 subthemes. The first main theme is about dyads who reported new and enriching ways of working together through the portal, particularly related to written communication and use of the goal module. Illustrative subthemes are ownership, common ground, goals and direction, and sense of presence and availability. The second main theme illuminates the difficulties that arose when service users’ and health providers’ expectations for portal use were not aligned, and the consequences of not addressing these difficulties. Illustrative subthemes are initiative and responsibility, waiting for the other, feeling overwhelmed, and clarifications and agreements. Conclusions The degree to which dyads benefited from using the e-recovery portal appeared to be mainly associated with the degree to which the dyads’ relations were open and flexible before the portal was introduced. For those who experienced frustrations, the portal may have both exposed and added to suboptimal working relationships. Use of the goal module appeared to strengthen the person-centered nature of collaboration. A key question is how health providers balance between enabling service users’ greater control over their care, without relinquishing responsibility for the quality of the working relationship, also when using an e-recovery portal. Implications for implementation are discussed.

scholarly journals Cross-national mixed-methods comparative case study of recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings (COCAPP-A)

2017 ◽  
Vol 5 (26) ◽  
pp. 1-234 ◽  
Author(s):  
Alan Simpson ◽  
Michael Coffey ◽  
Ben Hannigan ◽  
Sally Barlow ◽  
Rachel Cohen ◽  
...  
Keyword(s):  
Mental Health ◽  
Service User ◽  
Inpatient Care ◽  
Therapeutic Relationships ◽  
Future Research ◽  
Service Users ◽  
Care Planning ◽  
Recovery Orientation ◽  
Cross National

BackgroundMental health service users in acute inpatient wards, whether informal or detained, should be involved in planning and reviewing their care. Care planning processes should be personalised and focused on recovery, with goals that are specific to the individual and designed to maximise their achievements and social integration.Objective(s)We aimed to ascertain the views and experiences of service users, carers and staff to enable us to identify factors that facilitated or acted as barriers to collaborative, recovery-focused care and to make suggestions for future research.DesignA cross-national comparative mixed-methods study involving 19 mental health wards in six NHS sites in England and Wales included a metanarrative synthesis of policies and literature; a survey of service users (n = 301) and staff (n = 290); embedded case studies involving interviews with staff, service users and carers (n = 76); and a review of care plans (n = 51) and meetings (n = 12).ResultsNo global differences were found across the sites in the scores of the four questionnaires completed by service users. For staff, there was significant difference between sites in mean scores on recovery-orientation and therapeutic relationships. For service users, when recovery-orientated focus was high, the quality of care was viewed highly, as was the quality of therapeutic relationships. For staff, there was a moderate correlation between recovery orientation and quality of therapeutic relationships, with considerable variability. Across all sites, staff’s scores were significantly higher than service users’ scores on the scale to assess therapeutic relationships. Staff across the sites spoke of the importance of collaborative care planning. However, the staff, service user and carer interviews revealed gaps between shared aspirations and realities. Staff accounts of routine collaboration contrasted with service user accounts and care plan reviews. Definitions and understandings of recovery varied, as did views of the role of hospital care in promoting recovery. ‘Personalisation’ was not a familiar term, although there was recognition that care was often provided in an individualised way. Managing risk was a central issue for staff, and service users were aware of measures taken to keep them safe, although their involvement in discussions was less apparent.ConclusionsOur results suggest that there is positive practice taking place within acute inpatient wards, with evidence of widespread commitment to safe, respectful, compassionate care. Although ideas of recovery were evident, there was some uncertainty about and discrepancy in the relevance of recovery ideals to inpatient care and the ability of people in acute distress to engage in recovery-focused approaches. Despite the fact that staff spoke of efforts to involve them, the majority of service users and carers did not feel that they had been genuinely involved, although they were aware of efforts to keep them safe.Future workFuture research should investigate approaches that increase contact time with service users and promote personalised, recovery-focused working; introduce shared decision-making in risk assessment and management; and improve service user experiences of care planning and review and the use of recovery-focused tools during inpatient care.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Systematic synthesis of barriers and facilitators to service user-led care planning

2015 ◽  
Vol 207 (2) ◽  
pp. 104-114 ◽  
Author(s):  
Penny Bee ◽  
Owen Price ◽  
John Baker ◽  
Karina Lovell
Keyword(s):  
Mental Health ◽  
Service User ◽  
Planning Process ◽  
Evidence Synthesis ◽  
Mental Health Policy ◽  
User Involvement ◽  
Service Users ◽  
Care Planning ◽  
Service User Involvement

BackgroundService user (patient) involvement in care planning is a principle enshrined by mental health policy yet often attracts criticism from patients and carers in practice.AimsTo examine how user-involved care planning is operationalised within mental health services and to establish where, how and why challenges to service user involvement occur.MethodSystematic evidence synthesis.ResultsSynthesis of data from 117 studies suggests that service user involvement fails because the patients' frame of reference diverges from that of providers. Service users and carers attributed highest value to the relational aspects of care planning. Health professionals inconsistently acknowledged the quality of the care planning process, tending instead to define service user involvement in terms of quantifiable service-led outcomes.ConclusionsService user-involved care planning is typically operationalised as a series of practice-based activities compliant with auditor standards. Meaningful involvement demands new patient-centred definitions of care planning quality. New organisational initiatives should validate time spent with service users and display more tangible and flexible commitments to meeting their needs.

scholarly journals Relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe: cross-sectional study

2017 ◽  
Vol 211 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Tatiana Taylor Salisbury ◽  
Helen Killaspy ◽  
Michael King
Keyword(s):  
Mental Health ◽  
Quality Of Care ◽  
Service User ◽  
Health Expenditure ◽  
Multilevel Models ◽  
Service Users ◽  
Cross Sectional ◽  
National Mental Health ◽  
Mental Health Expenditure

BackgroundIt is not known whether increased mental health expenditure is associated with better outcomes.AimsTo estimate the association between national mental health expenditure and (a) quality of longer-term mental healthcare, (b) service users' ratings of that care in eight European countries.MethodNational mental health expenditure (per cent of health budget spent on mental health) was calculated from international sources. Multilevel models were developed to assess associations with quality of care and service user experiences of care using ratings of 171 facility managers and 1429 service users.ResultsSignificant positive associations were found between mental health spend and (a) six of seven quality of care domains; and (b) service user autonomy and experiences of care.ConclusionsGreater national mental health expenditure was associated with higher quality of care and better service user experience.

Now they’re listening: involvement in clinical psychology training

2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Clinical Psychology ◽  
Health Professionals ◽  
Service User ◽  
Health Workers ◽  
Psychology Training ◽  
Service Users ◽  
Clinical Psychology Training ◽  
Content Type

PurposeThe 2014/2015 UK requirement for involvement of service users and carers in training mental health professionals has prompted the authors to review the work of involvement in clinical psychology training in the university programme. Have the voices of service users and carers been heard? The paper aims to discuss this issue.Design/methodology/approachThe authors update the paper of 2011 in which the authors described the challenges of inclusion and the specific approaches the authors take to involvement. The authors do this in the context of the recent change to UK standards for service user and carer involvement, and recent developments in relation to partnership working and co-production in mental healthcare. The authors describe the work carried out by the authors – members of a service user involvement group at a UK university – to ensure the voices of people affected by mental health difficulties are included in all aspects of training.FindingsCareful work and the need for dedicated time is required to enable inclusive, effective and comprehensive participation in a mental health training programme. It is apparent that there is a group of service users whose voice is less heard: those who are training to be mental health workers.Social implicationsFor some people, involvement has increased. Trainee mental health professionals’ own experience of distress may need more recognition and valuing.Originality/valueThe authors are in a unique position to review a service-user-led project, which has run for 12 years, whose aim has been to embed involvement in training. The authors can identify both achievements and challenges.

scholarly journals To improve the communication between a community mental health team and its service users, their families and carers

2020 ◽  
Vol 9 (4) ◽  
pp. e000914
Author(s):  
Priyalakshmi Chowdhury ◽  
Amir Tari ◽  
Ola Hill ◽  
Amar Shah
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
User Satisfaction ◽  
Service User ◽  
Service Users ◽  
Not Given ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Specialist Registrar ◽  
Health Team

This article describes the application of quality improvement (QI) to solve a long-standing, ongoing problem where service users or their carers felt they were not given enough information regarding diagnosis and medication during clinic assessments in a community mental health setting. Service users and carers had shared feedback that some of the information documented on clinic letters was not accurate and the service users were not given the opportunity to discuss these letters with the clinician. The aim of this QI project was to improve the communication between the community mental health team (CMHT) and service users and their carers. Wardown CMHT volunteered to take on this project. The stakeholders involved were the team manager and deputy manager, the team consultant, the team specialist registrar, team administrative manager, two carers and one service user. The project had access to QI learning and support through East London NHS Foundation Trust’s QI programme. The team organised weekly meetings to brainstorm ideas, plan tests of change to review progress and to agree on the next course of action. The outcome was an increase in service user satisfaction from 59.9% to 78% over a period of 6 months, and a reduction in complaints to zero.

Persepsi Kreditur dan PPAT Terhadap Kualitas Layanan Hak Tanggungan Terintegrasi Secara Elektronik

Tunas Agraria ◽  
2020 ◽  
Vol 3 (3) ◽  
Author(s):  
I Made Dwi Gunarta ◽  
Akur Nurasa ◽  
Sukmo Pinuji
Keyword(s):  
Service Quality ◽  
User Satisfaction ◽  
Service User ◽  
Service Users ◽  
User Perception ◽  
Excellent Service ◽  
Efficiency And Effectiveness ◽  
Citizen Support

The success of the Badung Regency Land Office in issuing HT-el Certificate, the first in Indonesia cannot be separated from the support of the Creditors and PPAT as the main users of HT-el Services. This innovation is an effort to realize the digitalization of services and overcome various existing weaknesses. Creditors and PPAT as the main users are important instruments in providing an overview of HT-el service quality, because basically the success of an organization in providing a service depends on how well the perception of service users will reflect the level of user satisfaction and the profitability of the organization. HT-el Service User Perception (Creditor and PPAT) assessed using the e- Govqual Method illustrates that the Quality of HT-el Services at the Badung District Land Office is very good, this is evidenced by positive responses to the Efficiency, Trust and Realibility as well as Citizen Support. This is an effort to create excellent service in the land sector based on the principles of efficiency and effectiveness in implementing activities.

scholarly journals Study on the Content Validity of the Essential Assessment Items Required for Visiting Nurses to Service Users in Japan

2017 ◽  
Vol 2 (1) ◽  
pp. 8
Author(s):  
Izumi Ueda ◽  
Wakako Mizuguchi ◽  
Masahiko Sasaki ◽  
Madoka Yokoyama
Keyword(s):  
Content Validity ◽  
Service User ◽  
Nursing Practice ◽  
Service Users ◽  
Point Scale ◽  
Common View ◽  
Visiting Nurses ◽  
Final Assessment

Objective: We examined the content validity of the essential assessment items for service user recognized by visiting nurses. Methods: Anonymous self-reported questionnaire were sent by mail two times to nurses experts. The questionnaire comprised assessment items related to five major categories, and fist survey asked by 82 items, second survey asked by 83 items with 4-point scale. We analyzed the data using weighed average. Results: The final assessment items were 83. Conclusion: In the visiting nursing practice field, we think of easier ways to common view of assessment records all over the country and improvement of quality of visiting nursing practice by utilizing of assessment items of this study with considering of degree of priority.

Psychosocial concerns in a context of prolonged political oppression: Gaza mental health providers’ perceptions

2022 ◽  
pp. 136346152110629
Author(s):  
Marwan Diab ◽  
Guido Veronese ◽  
Yasser Abu Jamei ◽  
Rawia Hamam ◽  
Sally Saleh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Problems ◽  
Qualitative Interviews ◽  
Clinical Work ◽  
Mental Health Providers ◽  
Health Providers ◽  
Psychological Burden ◽  
Psychosocial Conditions

In this qualitative exploratory study, we investigated the perspectives of mental health providers in Gaza, Palestine, regarding the primary concerns of their clients who are exposed to low-intensity warfare and structural violence. We conducted qualitative interviews with 30 psychologists, social workers, psychiatric nurses, and psychiatrists providing services to communities in Gaza. Participants were asked to discuss their clients’ most commonly occurring mental health problems, diagnoses, and psychosocial conditions. Thematic analysis identified one superordinate theme (Impact of the Blockade on Mental Health and Quality of Life) and four second-order themes (Concerns about Social Problems, General Concerns about Quality of Life, Concerns about the Mental Health of the Community, and Concerns Related to Children's Mental Health). Participants indicated that the social and political dimensions of mental health and the economic, educational, and health-related consequences of the ongoing blockade of Gaza were the main determinants of psychological burden among their clients. Findings demonstrated the importance of adopting an approach to mental health that includes understanding psychological indicators in a broader framework informed by human rights and social justice. Implications for research and clinical work are discussed, including the role of investments in social capital that may provide individuals with access to resources such as social support, which may in turn promote overall mental health.

Developing a Rule-Based Expert System to Infer Customized Care Plans for Long Term Care Patients

2021 ◽  
Author(s):  
Chih-Hsuan Yeh ◽  
Chiao-Ling Hsu ◽  
Polan Chang
Keyword(s):  
Expert System ◽  
Long Term Care ◽  
Health Providers ◽  
Term Care ◽  
Rule Based ◽  
Care Plans ◽  
Aging Society ◽  
Increasing Demand

Systems of long-term care are needed in aging society to meet the needs of older people. In rapidly increasing demand for long-term care, how to ensure the quality of long-term care is an important issue. Therefore, we designed a rule-based expert system that automatically generates customized care plans based on the assessment results. Aims to provide health providers a useful tool in long term patients management.

Establishing working relationships in online social work

2016 ◽  
Vol 18 (3) ◽  
pp. 307-325 ◽  
Author(s):  
Guido van de Luitgaarden ◽  
Michelle van der Tier
Keyword(s):  
Social Work ◽  
Service User ◽  
Psychosocial Problems ◽  
Working Relationships ◽  
Service Users ◽  
Working Relationship ◽  
Online Chat ◽  
Service Workers ◽  
Work Education

Summary This article reports on an empirical case study into the process of establishing a working relationship between social workers and service users in an online social work service. Workers were using an online chat application to interact with young people, who sought professional help for various types of psychosocial problems. Two chat conversations and one interview of each of five research participants were analysed in terms of the way in which the working relationship between the service user and the online social worker was established. Thus, a total of 10 chat conversations and five interviews were included in this study. Findings Subjects were shown to be particularly focused on the process of addressing the issues with which the service users were trying to cope. As a consequence, limited effort was observed with regard to shaping the working relationship in such a way that the service user gained control over the course of the conversation. Applications As the medium influences the process of establishing a positive working relationship, it is argued that the worker should be able to understand the implications for the manner in which online conversations are conducted. Social work education is called upon to facilitate the acquiring of the knowledge and skills needed for such. It is suggested that more research into service users’ expectations regarding the working relationship within online social work could provide additional insights for the further improvement of these types of services.

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