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 Cross-national comparative mixed-methods case study of recovery-focused mental health care planning and co-ordination: Collaborative Care Planning Project (COCAPP)

2016 ◽  
Vol 4 (5) ◽  
pp. 1-190 ◽  
Author(s):  
Alan Simpson ◽  
Ben Hannigan ◽  
Michael Coffey ◽  
Aled Jones ◽  
Sally Barlow ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Risk Assessments ◽  
Service Users ◽  
Care Planning ◽  
Community Mental Health Care ◽  
Care Plans ◽  
Cross National

BackgroundConcerns about fragmented community mental health care have led to the development of the care programme approach in England and care and treatment planning in Wales. These systems require those people receiving mental health services to have a care co-ordinator, a written care plan and regular reviews of their care. Care planning and co-ordination should be recovery-focused and personalised, with people taking more control over their own support and treatment.Objective(s)We aimed to obtain the views and experiences of various stakeholders involved in community mental health care; to identify factors that facilitated, or acted as barriers to, personalised, collaborative and recovery-focused care planning and co-ordination; and to make suggestions for future research.DesignA cross-national comparative mixed-methods study involving six NHS sites in England and Wales, including a meta-narrative synthesis of relevant policies and literature; a survey of recovery, empowerment and therapeutic relationships in service users (n = 449) and recovery in care co-ordinators (n = 201); embedded case studies involving interviews with service providers, service users and carers (n = 117); and a review of care plans (n = 33).Review methodsA meta-narrative mapping method.ResultsQuantitative and qualitative data were analysed within and across sites using inferential statistics, correlations and the framework method. Our study found significant differences for scores on therapeutic relationships related to positive collaboration and clinician input. We also found significant differences between sites on recovery scores for care co-ordinators related to diversity of treatment options and life goals. This suggests that perceptions relating to how recovery-focused care planning works in practice are variable across sites. Interviews found great variance in the experiences of care planning and the understanding of recovery and personalisation within and across sites, with some differences between England and Wales. Care plans were seen as largely irrelevant by service users, who rarely consulted them. Care co-ordinators saw them as both useful records and also an inflexible administrative burden that restricted time with service users. Service users valued their relationships with care co-ordinators and saw this as being central to their recovery. Carers reported varying levels of involvement in care planning. Risk was a significant concern for workers but this appeared to be rarely discussed with service users, who were often unaware of the content of risk assessments.LimitationsLimitations include a relatively low response rate of between 9% and 19% for the survey and a moderate level of missing data on one measure. For the interviews, there may have been an element of self-selection or inherent biases that were not immediately apparent to the researchers.ConclusionsThe administrative elements of care co-ordination reduce opportunities for recovery-focused and personalised work. There were few shared understandings of recovery, which may limit shared goals. Conversations on risk appeared to be neglected and assessments kept from service users. A reluctance to engage in dialogue about risk management may work against opportunities for positive risk-taking as part of recovery-focused work.Future workResearch should be commissioned to investigate innovative approaches to maximising staff contact time with service users and carers; enabling shared decision-making in risk assessments; and promoting training designed to enable personalised, recovery-focused care co-ordination.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Training to enhance user and carer involvement in mental health-care planning: the EQUIP research programme including a cluster RCT

2019 ◽  
Vol 7 (9) ◽  
pp. 1-140 ◽  
Author(s):  
Karina Lovell ◽  
Penny Bee ◽  
Peter Bower ◽  
Helen Brooks ◽  
Patrick Cahoon ◽  
...  
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Service User ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Training Intervention ◽  
Service Users ◽  
Care Planning ◽  
Audit Tool ◽  
Patient Reported

Background Service users and carers using mental health services want more involvement in their care and the aim of this research programme was to enhance service user and carer involvement in care planning in mental health services. Objectives Co-develop and co-deliver a training intervention for health professionals in community mental health teams, which aimed to enhance service user and carer involvement in care planning. Develop a patient-reported outcome measure of service user involvement in care planning, design an audit tool and assess individual preferences for key aspects of care planning involvement. Evaluate the clinical effectiveness and the cost-effectiveness of the training. Understand the barriers to and facilitators of implementing service user- and carer-involved care planning. Disseminate resources to stakeholders. Methods A systematic review, focus groups and interviews with service users/carers/health professionals informed the training and determined the priorities underpinning involvement in care planning. Data from focus groups and interviews were combined and analysed using framework analysis. The results of the systematic review, focus groups/interviews and a review of the training interventions were synthesised to develop the final training intervention. To develop and validate the patient-reported outcome measure, items were generated from focus groups and interviews, and a psychometric analysis was conducted. Patient-reported outcome measure items and a three-round consensus exercise were used to develop an audit tool, and a stated preference survey was undertaken to assess individual preferences for key aspects of care planning. The clinical effectiveness and cost-effectiveness of the training were evaluated using a pragmatic cluster trial with cohort and cross-sectional samples. A nested longitudinal qualitative process evaluation using multiple methods, including semistructured interviews with key informants involved locally and nationally in mental health policy, practice and research, was undertaken. A mapping exercise was used to determine current practice, and semistructured interviews were undertaken with service users and mental health professionals from both the usual-care and the intervention arms of the trial at three time points (i.e. baseline and 6 months and 12 months post intervention). Results The results from focus groups (n = 56) and interviews (n = 74) highlighted a need to deliver training to increase the quality of care planning and a training intervention was developed. We recruited 402 participants to develop the final 14-item patient-reported outcome measure and a six-item audit tool. We recruited 232 participants for the stated preference survey and found that preferences were strongest for the attribute ‘my preferences for care are included in the care plan’. The training was delivered to 304 care co-ordinators working in community mental health teams across 10 NHS trusts. The cluster trial and cross-sectional survey recruited 1286 service users and 90 carers, and the primary outcome was the Health Care Climate Questionnaire. Training was positively evaluated. The results showed no statistically significant difference on the primary outcome (the Health Care Climate Questionnaire) (adjusted mean difference –0.064, 95% confidence interval –0.343 to 0.215; p = 0.654) or secondary outcomes at the 6-month follow-up. Overall, the training intervention was associated with a net saving of –£54.00 (95% confidence interval –£193.00 to £84.00), with a net quality-adjusted life-year loss of –0.014 (95% confidence interval –0.034 to 0.005). The longitudinal process evaluation recruited 54 service users, professionals and carers, finding a failure of training to become embedded in routine care. Limitations Our pragmatic study was designed to improve service user and care involvement in care planning among routine community mental health services. We intervened in 18 sites with > 300 care co-ordinators. However, our volunteer sites may not be fully representative of the wider population, and we lacked data with which to compare our participants with the eligible population. Conclusions We co-developed and co-delivered a training intervention and developed a unidimensional measure of service user and carer involvement in care planning and an audit tool. Despite a high level of satisfaction with the training, no significant effect was found; therefore, the intervention was ineffective. There was a failure of training to become embedded and normalised because of a lack of organisational readiness to accept change. Working with NHS trusts in our ‘Willing Adopters’ programme with enhanced organisational buy-in yielded some promising results. Future work Research should focus on developing and evaluating new organisational initiatives in addition to training health-care professionals to address contextual barriers to service and carer involvement in care planning, and explore co-designing and delivering new ways of enhancing service users’ and carers’ capabilities to engage in care planning. Trial registration Current Controlled Trials ISRCTN16488358. Funding This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.

scholarly journals Patient involvement in improving the evidence base on mental health inpatient care: the PERCEIVE programme

2018 ◽  
Vol 6 (7) ◽  
pp. 1-182 ◽  
Author(s):  
Til Wykes ◽  
Emese Csipke ◽  
Diana Rose ◽  
Thomas Craig ◽  
Paul McCrone ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Economic ◽  
Service User ◽  
Inpatient Care ◽  
Applied Research ◽  
Care Quality ◽  
Service Users ◽  
Participatory Methods ◽  
Inpatient Services ◽  
Economic Measure

BackgroundDespite the movement towards care in the community, 40% of the NHS budget on mental health care is still attributed to inpatient services. However, long before the Francis Report highlighted grave shortcomings in inpatient care, there were reports by service user groups on the poor quality of these services in mental health. The programme provides a particular focus on the inclusion of the patient’s perspective in the development and evaluation of evidence.ObjectivesTo understand how changes to inpatient care affect the perceptions of the ward by service users and staff by using stakeholder participatory methods.DesignThe programme consisted of four work packages (WPs). (1) Lasting Improvements for Acute Inpatient SEttings (LIAISE): using participatory methods we developed two new scales [Views On Therapeutic Environment (VOTE) for staff and Views On Inpatient CarE (VOICE) for service users]. (2) Client Services Receipt Inventory – Inpatient (CITRINE): working with nurses and service users we developed a health economic measure of the amount of contact service users have with staff. The self-report measure records interactions with staff as well as the number of therapeutic activities attended. (3) Delivering Opportunities for Recovery (DOORWAYS): a stepped-wedge randomised controlled trial to test if training ward nurses to deliver therapeutic group activities would improve the perception of the ward by service users and staff. A total of 16 wards were progressively randomised and we compared the VOICE, VOTE and CITRINE measures before and after the intervention. A total of 1108 service users and 539 staff participated in this trial. (4) Bringing Emergency TreatmenT to Early Resolution (BETTER PATHWAYS) was an observational study comparing two service systems. The first was a ‘triage’ system in which service users were admitted to the triage ward and then either transferred to their locality wards or discharged back into the community within 7 days. The second system was routine care. We collected data from 454 service users and 284 nurses on their perceptions of the wards.Main outcome measuresThe main outcomes for the DOORWAYS and BETTER project were service user and staff perceptions of the ward (VOICE and VOTE, respectively) and the health economic measure was CITRINE. All were developed in WPs 1 and 2.ResultsWe developed reliable and valid measures of (1) the perceptions of inpatient care from the perspectives of service users and nurses (VOICE and VOTE) and (2) costs of interactions that were valued by service users (CITRINE). In the DOORWAYS project, after adjusting for legal status, we found weak evidence for benefit (standardised effect of –0.18, 95% CI 0.38 improvement to 0.01 deterioration;p = 0.062). There was only a significant benefit for involuntary patients following the staff training (N582, standardised effect of –0.35, 95% CI –0.57 to –0.12;p = 0.002; interactionp-value 0.006). VOTE scores did not change over time (standardised effect size of 0.04, 95% CI –0.09 to 0.18;p = 0.54). We found no evidence of an improvement in cost-effectiveness (estimated effect of £33, 95% CI –£91 to £146;p = 0.602), but resource allocation did change towards patient-perceived meaningful contacts by an average of £12 (95% CI –£76 to £98;p = 0·774). There were no significant differences between the triage and routine models of admission in terms of better perceptions by service users (estimated effect 0.77-point improvement in VOICE score on the triage ward;p = 0.68) or nurses (estimated effect of 1.68-point deterioration in VOTE on the triage ward;p = 0.38) or in terms of the cost of the length of care provided (£391 higher on triage;p = 0.77).Strengths and limitationsWe have developed measures using methods involving both service users and staff from mental health services. The measures were developed specifically for acute inpatient services and, therefore, cannot be assumed to be useful for other services. For instance, extensions of the measures are under construction for use in mother and baby units. The strength of the BETTER PATHWAYS and DOORWAYS projects is the large-scale data collection. However, we were testing specific services based in inner city areas and stretching to inner urban areas. It may be that different effects would be found in more rural communities or in different types of inpatient care.Future workOur database will be used to develop an understanding of the mediating and moderating factors for improving care quality.Trial registrationCurrent Controlled Trials ISRCTN06545047.FundingThis project was funded by the NIHR Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 6, No. 7. See the NIHR Journals Library website for further project information.

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 Early Psychosis Service User Views on Digital Technology: Qualitative Analysis (Preprint)

2018 ◽  
Author(s):  
Sandra Bucci ◽  
Rohan Morris ◽  
Katherine Berry ◽  
Natalie Berry ◽  
Gillian Haddock ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Digital Technology ◽  
Service User ◽  
Care Delivery ◽  
Digital Health ◽  
Early Psychosis ◽  
Treatment Modalities ◽  
Future Research ◽  
Service Users

BACKGROUND Digital technology has the potential to improve outcomes for people with psychosis. However, to date, research has largely ignored service user views on digital health interventions (DHIs). OBJECTIVE The objective of our study was to explore early psychosis service users’ subjective views on DHIs. METHODS Framework analysis was undertaken with data obtained from 21 semistructured interviews with people registered with early intervention for psychosis services. Robust measures were used to develop a stable framework, including member checking, triangulation, independent verification of themes, and consensus meetings. RESULTS The following 4 themes were established a priori: acceptability of technology in psychosis and mental health; technology increasing access to and augmenting mental health support; barriers to adopting DHIs; and concerns about management of data protection, privacy, risk, and security of information. The following 2 themes were generated a posteriori: blending DHIs with face-to-face treatment and empowerment, control, and choice. DHIs were also viewed as potentially destigmatizing, overcoming barriers faced in traditional service settings, facilitating communication, and empowering service users to take active control of their health care. CONCLUSIONS In the first study of its kind, early psychosis service users’ were largely positive about the potential use of DHIs supporting and managing mental health. Overall, service users felt that DHIs were a progressive, modern, and relevant platform for health care delivery. Concerns were expressed around privacy and data security and practical barriers inherent within DHIs, all of which require further attention. Future research should explore whether findings transfer to other service user groups, other technology delivery formats, and across a range of treatment modalities.

Sähköiset mielenterveyspalvelut toipumisen näkökulmasta. Integroiva kirjallisuuskatsaus

Kuntoutus ◽  
2020 ◽  
Vol 43 (3) ◽  
pp. 34-50
Author(s):  
Mari Kivistö
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Future Research ◽  
Service Users ◽  
Personal Recovery ◽  
Recovery Orientation ◽  
Digital Services ◽  
Mental Health Practices

Mielenterveyden häiriöiden merkityksen kasvaminen sekä haasteet mielenterveyspalveluiden järjestämisessä ovat tehneet sähköisten mielenterveyspalveluiden kehittämisestä ja tutkimuksesta ajankohtaista. Nyt COVID-19-pandemia on lisännyt sähköisten mielenterveyspalveluiden tarvetta mutta tuonut samalla näkyviksi organisaatioiden eriytyvät lähtökohdat sähköisten mielenterveyspalveluiden järjestämisessä. Tämän tutkimuksen tavoitteena oli kuvata sähköisten mielenterveyspalveluiden vaikutuksia palvelunkäyttäjien näkökulmasta sekä tunnistaa positiivisesti vaikuttavien sähköisten mielenterveyspalveluiden edellytyksiä. Tutkimus toteutettiin kansainvälisistä tutkimusartikkeleista (n = 27) tietoa kokoavana integroivana kirjallisuuskatsauksena. Analyysimenetelmänä sovellettiin teemoittelua ja tulkintakehyksenä toipumisorientaation (recovery) viitekehystä. Kirjallisuuskatsauksen perusteella sähköiset mielenterveyspalvelut tarjoavat mahdollisuuksia toipumiseen ja sen tukemiseen, mutta toipuminen ehdollistuu sähköisiin mielenterveyspalveluihin liittyvissä toimintakäytännöissä. Tulokset jäsennettiin yksilön laaja-alaista toipumista ja toipumista kokonaisvaltaisesti tukevia sähköisiä mielenterveyspalveluja ilmentävinä yläteemoina, joista edelliseen sisällytettiin alateemat kliininen toipuminen, henkilökohtainen toipuminen ja osallisuuden vahvistuminen ja jälkimmäiseen tietoperusteisuus, tilannekohtaisuus, tuen tarjoaminen, vuorovaikutteisuus, henkilökohtaisuus ja asiakaslähtöisyys. Kirjallisuuskatsaus osoittaa, että tutkimustarpeista huolimatta tiedämme jo paljon tekijöistä, jotka mahdollistavat toipumista edistävien sähköisten mielenterveyspalveluiden toteuttamista. Tätä tietoa on tarpeen hyödyntää myös COVID-19-pandemian muuttamassa toimintaympäristössä. Tulosten sovellettavuutta rajoittaa tutkimustiedon pirstaleisuus sekä se, että tutkimukset kohdistuivat vain henkilöihin, joilla oli pääsy, kyky ja halu sähköisten mielenterveyspalveluiden käyttöön.Abstract Digital mental health services and recovery. An Integrative literature review The increase of mental health disorders and the challenges of delivering mental health services have made the development and research of digital mental health services topical. Currently, the COVID-19 pandemic has increased the need for digital mental health services, but at the same time it has made visible the various potential of organizations for providing digital services. The aim of this study is to describe the effects of digital mental health services from the service users’ perspective and to identify the features of the services that make an impact. The study was conducted as an integrative literature review of international research articles (n = 27). The method used was thematic analysis and a recovery orientation was applied as the interpretation framework. Based on the review, digital mental health services offer opportunities for and support the recovery of service users, but the recovery is conditioned on digital mental health practices. The results were presented as two main-themes: a person’s extensive recovery and digital mental health services that support recovery holistically. The former includes the sub-themes of clinical recovery, personal recovery and participation, and the latter the sub-themes of knowledge orientation, situationality, provision of support, interactivity, personality and client orientation. The integrative literature review shows that despite the need for future research, we already know a great deal about the factors that enable the implementation of digital mental health services that promote recovery. This knowledge needs to be utilized in the operating environment of mental health services, which is currently changing because of the COVID-19 pandemic. The review has some limitations, because research on the subject is fragmentary and the studies involved in the review were only targeted at persons with access to digital mental health services and the ability and motivation to use them. Keywords: mental health, digital services, recovery, integrative literature review

The recovery-orientation of three mental health units

2014 ◽  
Vol 19 (3) ◽  
pp. 163-175 ◽  
Author(s):  
Hollie Bass ◽  
Anna Tickle ◽  
Nicholas Lewis
Keyword(s):  
Mental Health ◽  
Service User ◽  
Service Development ◽  
Service Improvement ◽  
Service Users ◽  
Cross Sectional ◽  
Content Type ◽  
Staff Members ◽  
Recovery Orientation ◽  
Cross Sectional Design

Purpose – The purpose of this paper is to measure service user and staff views of the recovery orientation of three mental health rehabilitation units; two “open” and one “locked”. It identified elements of recovery that were important to service users. It measured the units’ performance on domains of recovery, attending to differences between staff members’ and service users’ perceptions and between the locked and open units. Design/methodology/approach – A cross-sectional design was used. Staff and service users completed the “Developing Recovery Enhancing Environment Measure (DREEM)”. Findings – Findings revealed some differences between staff and service user views. Service users in the locked unit reported the organisational climate to be more recovery oriented on some domains than those in the open units. Service users’ responses highlighted potential areas for service improvement. Research limitations/implications – The sample was small but reflected the applied setting. Some service users were not invited to participate because of significant communication or cognitive difficulties and it is recognised that they may have had alternative views that remain unrepresented. Practical implications – The DREEM provided valuable information about current practice and potential for service development. Both locked and open units can provide recovery-oriented environments. Services should be aware of discrepant views between staff and service users. Originality/value – To the knowledge, this is the first study to use the DREEM to evaluate the recovery orientation of a locked recovery unit and to compare locked and unlocked units.

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.

scholarly journals Early Psychosis Service User Views on Digital Technology: Qualitative Analysis

10.2196/10091 ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. e10091 ◽  
Author(s):  
Sandra Bucci ◽  
Rohan Morris ◽  
Katherine Berry ◽  
Natalie Berry ◽  
Gillian Haddock ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Digital Technology ◽  
Service User ◽  
Care Delivery ◽  
Digital Health ◽  
Early Psychosis ◽  
Treatment Modalities ◽  
Future Research ◽  
Service Users

Background Digital technology has the potential to improve outcomes for people with psychosis. However, to date, research has largely ignored service user views on digital health interventions (DHIs). Objective The objective of our study was to explore early psychosis service users’ subjective views on DHIs. Methods Framework analysis was undertaken with data obtained from 21 semistructured interviews with people registered with early intervention for psychosis services. Robust measures were used to develop a stable framework, including member checking, triangulation, independent verification of themes, and consensus meetings. Results The following 4 themes were established a priori: acceptability of technology in psychosis and mental health; technology increasing access to and augmenting mental health support; barriers to adopting DHIs; and concerns about management of data protection, privacy, risk, and security of information. The following 2 themes were generated a posteriori: blending DHIs with face-to-face treatment and empowerment, control, and choice. DHIs were also viewed as potentially destigmatizing, overcoming barriers faced in traditional service settings, facilitating communication, and empowering service users to take active control of their health care. Conclusions In the first study of its kind, early psychosis service users’ were largely positive about the potential use of DHIs supporting and managing mental health. Overall, service users felt that DHIs were a progressive, modern, and relevant platform for health care delivery. Concerns were expressed around privacy and data security and practical barriers inherent within DHIs, all of which require further attention. Future research should explore whether findings transfer to other service user groups, other technology delivery formats, and across a range of treatment modalities.

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