Does Anyone Care about Names? How Attendees at Substance Misuse Services Like to Be Addressed by Health Professionals

Abstract

Objective: To determine the preference of substance misusers for the terms ‘patient’, ‘client’ and ‘service user’ in the context of their contact with health professionals, if they consider substance misuse problems to exist appropriately under the category of mental health problems and if they consider themselves to have mental health problems. Methods: A self-completion questionnaire was administered to 150 National Health Service and private in- and outpatients with alcohol, drug and smoking problems. Results: The majority (54%) preferred the term ‘patient’, felt substance misuse problems was a category of mental health problems (59%), even though the majority (62%) did not consider themselves to have a mental health problem. Broadly similar preferences were found for those attending drug services and alcohol services whilst those attending the smoking cessation service were less likely to consider it an appropriate location or description. Discussion: The majority of substance misusers preferred to be called ‘patients’. The location of substance misuse services within mental health provision was widely tolerated.

Labelling people who are resident in a secure forensic mental health service: user views

“…We have previously noted international variation in terminological preference with studies in the UK, Canada and Ireland reporting a preference for 'patient' and those in the US and Australia for 'client' (Dickens & Picchioni, 2011). Despite the forensic/secure context of the study setting including very high levels of involuntary detention, results were similar to those reported in the studies of UK adult psychiatric outpatient (Ritchie et al, 2000), general inpatient (Upton et al, 1994) and mixed samples (Keaney et al, 2004;McGuireSnieckus et al, 2003;Simmons et al, 2010). It seems likely, therefore, that the attitudes and preferences of people resident in forensic services about terminology simply reflect those of people who use general mental health services, and, we speculate those of wider society.…”

“…A recent systematic review (Dickens & Picchioni, 2011) has highlighted that there has been considerable debate and contrasting opinion about these terms. A number of studies have attempted to ascertain preference for these terms from people who use mental health services (Covell, McCorkle, Weissman, Summerfelt, & Essock, 2007;Cybulska, 1994;Keaney et al, 2004;Lloyd, King, Bassett, Sandland, & Sarige, 2001;McGuire-Snieckus, McCabe, & Priebe, 2003;Mueser, Glynn, Corrigan, & Baber, 1996;Ritchie, Hayes, & Ames, 2000;Sharma, Whitney, Kazarian, & Manchanda, 2000;Simmons et al, 2010;Swift, Mazly, & Casey, 2000;Upton, Harm Boer, & Neale, 1994). However, only one (Covell et al, 2007) met more than half of 12 indicators of study quality including information about the aims and objectives, the study sample, the independence of the researchers and study funding, response rate, question development and wording, and generalisability (Dickens & Picchioni, 2011).…”

A systematic review of the terms used to refer to people who use mental health services: User perspectives

“…Participants were usually working age adults from general psychiatric services, usually with serious and enduring mental illness. Exceptions were two studies that included people over 65 years (Cybulska, 1994; Upton et al, 1994), while one study (Keaney et al, 2004) drew its sample from a substance misuse service. It was established in this latter survey that most respondents were comfortable being categorized as having a mental health problem.…”

“…In the US and elsewhere, additional terms used have included ‘consumer’ (Stocks, 1997), ‘customer’ (Kensinger, 2000) and ‘survivor’ (Rada, 1996). Ironically, studies to ascertain which term is preferred have themselves added to the lexicon ‘recipients’ (Lloyd et al, 2001; Sharma et al, 2000; Simmons et al, 2010) and ‘attendees’ (Keaney et al, 2004).…”

Service user, patient, survivor or client … has the time come to return to ‘patient’?

“…A number of studies have been conducted that answer the important question: what do people who receive mental healthcare want to be called? [1][2][3][4][5][6][7][8][9][10][11] These studies have collectively polled 4369 people in five different countries: USA (n = 2204), UK (n = 979), Poland (n = 634), Canada (n = 427) and Australia (n = 125). Although there are some caveats (not all studies compared the same terms in the same populations, for example) the answer is almost certainly 'patient' and it is assuredly not 'service user'.…”