A study at two outpatient facilities compared two methods of collecting data on client satisfaction with mental health services provided by case managers and by physicians. A satisfaction survey instrument was developed with input from clients. A total of 120 clients were randomly assigned to be interviewed by either a staff member or a client. Clients from both facilities reported high levels of satisfaction regardless of the type of interviewer. Clients gave a significantly greater number of extremely negative responses when they were interviewed by client interviewers. No difference between the two groups was found in overall satisfaction with services received from case managers or physicians.
Eliciting client satisfaction with services has become common in mental health settings and in the planning of service delivery systems. It is also compatible with the client-centred practice of occupational therapy. The traditional approach to collecting satisfaction information involves staff interviewing clients using questionnaires developed by staff. However, there is often a lack of variability in responses and the vast majority of clients report being satisfied. A review of the literature reveals that these favourable reports may be a result of social desirability and of clients being interviewed by treatment providers who have the power to give or withhold care. This paper reviews the relationship between occupational therapy and client involvement, examines the rationale for involving clients in programme evaluation and research, reviews the limitations with traditional methods of collecting information about client satisfaction, and discusses how clients are involved in evaluation and research in today's mental health care setting.
Although this engagement strategy demonstrated an impact, more substantial change in inpatient practices likely requires a broader set of strategies that address skill levels and accountability.
Empowerment has achieved a prominent position in the doctrine of community mental health. This paper conceptualizes empowerment, describes its historical development in the field and its relation to power theory. While there has been a recent erosion of social-political forces enabling empowerment, we contend a legacy of empowerment will endure. Four examples of this legacy are discussed: (a)focus on social determinants of health; (b) development of conceptual models; (c) tolerance for professional self-reflection; and (d) growth of formal consumer controlled organizations.
Case management has been identified as an effective approach to service delivery which can assist persons with severe psychiatric disabilities to live in the community. The conceptualization and development of case management services have been the focus of much discussion. Occupational therapists are attempting to define their role in relation to case management. The purpose of this paper is to explore the relationship between occupational therapy and the case management approach to service delivery. The case management approach will be described including its objectives, models, functions and training requirements for case managers. A discussion of some of the philosophical, educational and professional issues facing occupational therapists in the role of case manager will be examined.
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