Continuity of care for people with non-psychotic disorders

Catty, Jocelyn; Cowan, Naomi; Poole, Zoe; Clément, Sarah; Ellis, Gemma; Geyer, Connie; Lissouba, Pascale; Molodynski, Andrew; White, Sarah; Burns, Tom

doi:10.1177/0020764011421442

Cited by 8 publications

(11 citation statements)

References 11 publications

(12 reference statements)

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“…of moving within and between services). An extension to the ECHO study investigated the COC experiences of service users’ who did not have diagnoses of psychosis …”

Section: Methodsmentioning

confidence: 99%

“…An extension to the ECHO study investigated the COC experiences of service users' who did not have diagnoses of psychosis. 25 Participants were recruited from local CMHTs, service user groups and day centres. All CMHT service users eligible for inclusion were invited to participate via information sheets distributed by CMHT staff.…”

Section: Service User Participantsmentioning

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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“…of moving within and between services). An extension to the ECHO study investigated the COC experiences of service users’ who did not have diagnoses of psychosis …”

Section: Methodsmentioning

confidence: 99%

Section: Service User Participantsmentioning

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

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“…Differences in subjective QoL between patients with severe mental illnesses (defined here as schizophrenia, schizoaffective disorders and bipolar affective disorders) and non-severe mental diagnoses (such as depression and anxiety disorders)—referred to as SMI and non-SMI, are inconsistent [3]. Several studies show significantly better QoL among patients with SMI diagnoses than among those with non-SMI diagnoses [6–9]. More research is needed both to explore why patients with SMI diagnoses report better QoL than other diagnostic groups and because not all findings can be generalised from one diagnostic group to others [9].…”

Section: Introductionmentioning

confidence: 99%

“…The present study focuses on patients’ experiences of CoC. Better perceived CoC has been found to be associated with better QoL in a number of studies [6, 7, 11, 13], although these have almost exclusively involved people with SMI as this group is considered more complex and more difficult to achieve continuity with. One exception is Catty and colleagues’ study of people with non-psychotic disorders [6].…”

Section: Introductionmentioning

confidence: 99%

Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses

et al. 2018

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Purpose Our study investigated quality of life (QoL) in patients with severe or non-severe mental illness diagnoses (SMI and non-SMI) and the association between QoL and service satisfaction measured as patients’ perception of continuity of care (CoC), therapeutic relationship, and unmet service needs. Methods We conducted a national cross-sectional survey among 3836 mental health outpatients, of whom 1327 (34.6%) responded. We assessed QoL with the Manchester Short Assessment of Quality of Life (MANSA), CoC with the CONTINUUM, the therapeutic relationship with the Therapeutic Relationship in Community Mental Health Care (STAR-P) and developed a simple scale to measure unmet service needs. Results Outpatients with SMI ( n = 155) reported significantly better QoL than those with non-SMI ( n = 835) ( p = 0.003). In both groups, QoL was positively associated with cohabitation ( p = 0.007 for non-SMI and p = 0.022 for SMI), good contact with family and friends ( p < 0.001 for both) and positive ratings of CoC ( p < 0.001 for non-SMI and p = 0.008 for SMI). A positive association between QoL and therapeutic relationship ( p = 0.001) and a negative association between QoL and unmet needs for treatment ( p = 0.009) and activity ( p = 0.005) was only found in the non-SMI group. Conclusion Our study highlights the important differences between those with SMI and those with non-SMI in their reported QoL and in the relationship between QoL and service satisfaction, with only non-SMI patients’ QoL influenced by the therapeutic relationship and unmet needs for treatment and activity. It also shows the importance of continuity of care and social factors for good QoL for both groups.

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“…The two diagnostic groups constitute the great majority of patients treated in assertive outreach teams in the Netherlands; 23 but previous studies have largely focused on patients with psychotic disorders and ignored the experiences of service users with personality disorders in motivational interventions and/or outcome feedback systems. 15 , 37 , 38 Therefore, exploratory analyses were performed to detect whether the effects of treatment on all outcomes were modified by the primary diagnosis. Additionally, as previous studies in community mental health care for patients with SMI in the Netherlands have shown that treatment outcomes such as psychosocial functioning were dependent on patient age, 39 it was decided to explore whether the effects of treatment on all outcomes were modified by age.…”

Section: Methodsmentioning

confidence: 99%

The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial

Jochems¹,

Feltz-Cornelis²,

Dam³

et al. 2015

NDT

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ObjectiveTo evaluate the effectiveness of providing clinicians with regular feedback on the patient’s motivation for treatment in increasing treatment engagement in patients with severe mental illness.MethodsDesign: cluster randomized controlled trial (Dutch Trials Registry NTR2968). Participants: adult outpatients with a primary diagnosis of a psychotic disorder or a personality disorder and their clinicians, treated in 12 community mental health teams (the clusters) of two mental health institutions in the Netherlands. Interventions: monthly motivation feedback (MF) generated by clinicians additional to treatment as usual (TAU) and TAU by the community mental health teams. Primary outcome: treatment engagement at patient level, assessed at 12 months by clinicians. Randomization: teams were allocated to MF or TAU by a computerized randomization program that randomized each team to a single treatment by blocks of varying size. All participants within these teams received similar treatment. Clinicians and patients were not blind to treatment allocation at the 12-month assessment.ResultsThe 294 randomized patients (148 MF, 146 TAU) and 57 clinicians (29 MF, 28 TAU) of 12 teams (6 MF, 6 TAU) were analyzed according to the intention-to-treat principle. No statistically significant differences between treatment groups on treatment engagement were found (adjusted mean difference =0.1, 95% confidence interval =−2.2 to 2.3, P=0.96, d=0). Preplanned ancillary analyses showed statistically significant interaction effects between treatment group and primary diagnosis on treatment motivation and quality of life (secondary outcomes), which were beneficial for patients with a primary diagnosis of a personality disorder but not for those with a psychotic disorder. There were no reports of adverse events.ConclusionThe current findings imply that monitoring and discussing the patient’s motivation is insufficient to improve motivation and treatment engagement, and suggests that more elaborate interventions for severe mental illness patients are needed.

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Continuity of care for people with non-psychotic disorders

Abstract: The underlying concepts of continuity of care derived from users with psychotic disorders appear to be meaningful for users with non-psychotic disorders. Their greater likelihood of experiencing disruptive and distressing care transitions needs to be addressed.

Cited by 8 publications

References 11 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

Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses

The effects of motivation feedback in patients with severe mental illness: a cluster randomized controlled trial

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