A cross‐sectional survey of mental health service users’, carers’ and professionals’ priorities for patient safety in the United Kingdom

Abstract

BackgroundEstablishing patient safety priorities in psychiatry has received less international attention than in other areas of health care. This study aimed to identify safety issues as described by people in the United Kingdom identifying as mental health service users, carers and professionals.MethodsA cross‐sectional online survey was distributed via social media. Identified safety issues were mapped onto the Yorkshire Contributory Factors Framework (YCFF) which categorizes factors that contribute to patient safety incidents in general hospital settings. Service user and carer responses were described separately from professional responses using descriptive statistics.ResultsOne hundred and eighty‐five responses from 95 service users and carers and 90 professionals were analysed. Seventy different safety issues were identified. These were mapped onto the 17 existing categories of the YCFF and two additional categories created to form the YCFF‐MH. Most frequently identified issues were as follows: “Individual characteristics” (of staff) which included competence and listening skills; “Service process” that contained concerns about waiting times; “Management of staff and staffing levels” dominated by staffing levels; and “External policy context” which included the overall resourcing of services. Professionals identified staffing levels and inadequate community provision more frequently than service users and carers, who in turn identified crisis care more frequently.ConclusionsThis study updates knowledge on stakeholder perceived safety issues across mental health care. It shows a far broader range of issues relating to safety than has previously been described. The YCFF was successfully modified to describe these issues and areas for further coproduced research are suggested.

Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study

“…In the Australian mental health system, “safety” is synonymous with “risk,” and a risk‐averse approach is a central tenet of the model of care (Crowe & Deane, 2018). As a result, admission to an acute unit is often oriented towards risks to physical safety such as suicide, self‐harm, substance misuse or aggression (Berzins, Baker, Brown, & Lawton, 2018). While many consumers describe feeling physically safe in acute units, others describe their emotional and psychological safety as being compromised in this setting (Isobel, 2019).…”

Health professionals’ perspectives of safety issues in mental health services: A qualitative study

“…A semi‐structured interview guide was developed based on the initial analysis of the previous survey study exploring the same topic (Berzins et al . 2018). The survey questions used in this previous study were developed with input from people with lived experience of mental health problems.…”

“…Likewise, there is a lack of research exploring patient safety issues in mental health services, a unique service where care can be delivered across hospital, community and third sector settings (Berzins et al . 2018; Brickell et al . 2009; D'Lima et al .…”

“…Yet the perception of safety issues from perspectives of patients, carers and health professionals remains under researched (Berzins et al . 2018; Berzins et al . 2020; Thibaut et al .…”

“…Safety concerns identified included staff competence and poor attitudes, shortage of staff, long waiting times and high thresholds for accessing services (Berzins et al . 2018). This current study builds on this research by taking a qualitative approach to generate a richer understanding of health professionals’ views of safety issues in mental health care.…”