Continuity of care for people with psychotic illness: Its relationship to clinical and social functioning

Catty, Jocelyn; White, Sarah; Clément, Sarah; Cowan, Naomi; Geyer, Connie; Harvey, Kate; Jones, Ian Rees; McLaren, Susan; Poole, Zoe; Rose, Diana; Wykes, Til; Burns, Toms

doi:10.1177/0020764011421440

Cited by 34 publications

(41 citation statements)

References 30 publications

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“…An exploratory qualitative design was implemented in Community Mental Health Teams (CMHTs) in two National Health Service (NHS) Mental Health Trusts in London within the timescale of a broader programme of COC research (The ECHO Study, 2001–2007) . The Trusts were based in two inner‐city areas with high Jarman indices and a suburban area with a lower Jarman index in order to recruit service users from different sociodemographic groups.…”

Section: Methodsmentioning

confidence: 99%

“…Consequently, this study aimed to explore and compare service user and professional definitions of COC. The study was conducted as part of a wider programme of research which aimed to investigate experiences of COC and relationships to health and social outcomes (The ECHO study: Experiences of Continuity of Care and Health and Social Outcomes) . Within this broad research programme, participatory research with service users explored their definitions, perspectives and experiences of COC with the primary aim of generating an outcome measure of experienced COC (CONTINU‐UM) .…”

Section: Introductionmentioning

confidence: 99%

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Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Sweeney

Davies

McLaren

et al. 2015

Health Expectations

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BackgroundContinuity of care (COC) is central to the organization and delivery of mental health services. Traditional definitions have excluded service users, and this lack of involvement has been linked to poor conceptual clarity surrounding the term. Consequently, very little is known about the differences and similarities in the conceptualization of COC by mental health service users and professionals.ObjectiveTo explore and compare mental health service users’ and professionals’ definitions of COC.MethodsUsing an exploratory, qualitative design, five focus groups with 32 service users each met twice. Data were analysed thematically to generate a service user‐defined model of COC. In a cross‐sectional survey, health and social care professionals (n = 184) defined COC; responses were analysed thematically. Service user and professional definitions were conceptually mapped and compared to identify similarities and differences.ResultsThere was crossover between the service user and professional derived models of COC. Both contained temporal, quality, systemic, staff, hospital and needs‐related elements of COC. Service users prioritized access, information, peer support and avoiding services; health professionals most frequently referred to staff, cross‐sectional and temporal COC. Service users alone identified service avoidance, peer support and day centres as COC elements; professionals alone identified cross‐sectional working.ConclusionsImportant similarities and differences exist in service user and professional conceptualizations of COC. Further research is necessary to explore these differences, prior to integrating service user and professional perspectives in a validated COC framework which could enable the development and evaluation of interventions to improve COC, informing policy and practice.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Sweeney

Davies

McLaren

et al. 2015

Health Expectations

Self Cite

View full text Add to dashboard Cite

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“…Previous studies have suggested that continuity of care is positively associated with health outcomes among persons with severe mental illness [2]. More recently, continuity of care was linked to better social functioning of people with chronic psychotic disorders [3]. However, despite the availability of effective pharmacological and psychosocial treatments for the management of psychotic disorders, treatment is impended by high rates of disengagement from mental health services and poor adherence to antipsychotic medication.…”

Section: Introductionmentioning

confidence: 99%

Treatment Engagement of Psychotic Patients with a Mobile Mental Health Unit in Rural Areas in Greece: A Five-Year Study

Peritogiannis¹,

Tatsioni

Menti³

et al. 2013

Schizophrenia Research and Treatment

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Objectives. Treatment of psychotic disorders is impended by high rates of disengagement from mental health services and poor adherence to antipsychotic medication. This study examined the engagement rates of psychotic patients with a community mental health service during a 5-year period. Methods. The Mobile Mental Health Unit of Ioannina and Thesprotia (MMHU I-T) delivers services in remote, rural, mountainous areas using the resources of the primary care system. Clinical and demographic information for patients with a diagnosis of schizophrenia and related psychoses was obtained from the medical records of our unit. Results. A total of 74 psychotic patients initially engaged in treatment with our unit. In half of cases treatment was home-based. With the exclusion of patients who died or discharged, engagement rates were 67.2%. Statistical analysis was performed for 64 patients, and no differences were found between engaged and disengaged patients regarding clinical and demographic parameters. All engaged patients regularly refilled their antipsychotic prescriptions. Conclusion. Engagement rates in our study were comparable to previous research, involving urban settings and shorter follow-up duration. Community mental health teams may ensure treatment continuation for psychotic patients in deprived, remote areas. This is important for low-income countries, affected by economic crisis, such as Greece.

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“…For example, assuming a baseline standard deviation of Empowerment equal to 10.7 - as found in a sample of Community Mental Health Team service users with psychotic disorders [37] - a within site effect size of 0.49 equates to a change in Empowerment of 5.2. To allow for a realistic 20% attrition of the sample between baseline and 9 month follow up, we aimed to recruit 40 service users at each site.…”

Section: Methodsmentioning

confidence: 99%

Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

Gillard

Adams

Edwards

et al. 2012

BMC Health Serv Res

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BackgroundSupporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems.MethodsA mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together.ResultsParticipants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health.ConclusionsService delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings.

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Continuity of care for people with psychotic illness: Its relationship to clinical and social functioning

Abstract: Continuity is a dynamic process, influenced significantly by care structures and organizational change.

Cited by 34 publications

References 30 publications

Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Treatment Engagement of Psychotic Patients with a Mobile Mental Health Unit in Rural Areas in Greece: A Five-Year Study

Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England

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