Mental health service users' experiences of mental health care: an integrative literature review

Abstract

Accessible summary A number of studies have highlighted issues around the relationship between service users and providers. The recovery model is predominant in mental health as is the recognition of the importance of person‐centred practice. The authors completed an in‐depth search of the literature to answer the question: What are service users' experiences of the mental health service? Three key themes emerged: acknowledging a mental health problem and seeking help; building relationships through participation in care; and working towards continuity of care. The review adds to the current body of knowledge by providing greater detail into the importance of relationships between service users and providers and how these may impact on the delivery of care in the mental health service. The overarching theme that emerged was the importance of the relationship between the service user and provider as a basis for interaction and support. This review has specific implications for mental health nursing. Despite the recognition made in policy documents for change, issues with stigma, poor attitudes and communication persist. There is a need for a fundamental shift in the provider–service user relationship to facilitate true service‐user engagement in their care. Abstract The aim of this integrative literature review was to identify mental health service users' experiences of services. The rationale for this review was based on the growing emphasis and requirements for health services to deliver care and support, which recognizes the preferences of individuals. Contemporary models of mental health care strive to promote inclusion and empowerment. This review seeks to add to our current understanding of how service users experience care and support in order to determine to what extent the principles of contemporary models of mental health care are embedded in practice. A robust search of Web of Science, the Cochrane Database, Science Direct, EBSCO host (Academic Search Complete, MEDLINE, CINAHL Plus Full‐Text), PsycINFO, PsycARTICLES, Social Sciences Full Text and the United Kingdom and Ireland Reference Centre for data published between 1 January 2008 and 31 December 2012 was completed. The initial search retrieved 272 609 papers. The authors used a staged approach and the application of predetermined inclusion/exclusion criteria, thus the numbers of papers for inclusion were reduced to 34. Data extraction, quality assessment and thematic analysis were completed for the included studies. Satisfaction with the mental health service was moderately good. However, accessing services could be difficult because of a lack of knowledge and the stigma surrounding mental health. Large surveys document moderate satisfaction ratings; however, feelings of fear regarding how services function and the lack of treatment choice remain. The main finding from this review is while people may express satisfaction with mental health services, there are still issues around three main themes: acknowledging a mental health problem and seekin...

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“…This, institutional-led rather than collaborative, recovery dynamic was further illuminated in a recent, internationally-focused integrative literature review of mental health service users' experiences of mental health care. Newman et al (2015) describe a lack of user involvement in the care planning process as a major finding. These authors argue that this stems from limited opportunities reported by users to express their views about both their care needs and what should be included in their care plans.…”

“…They report that where this is achieved, service user involvement is often rarely implemented, in spite of policy directives to the contrary. This tension at the heart of care planning speaks to a related tension between the meaning of 'recovery' at institutional psychiatric and service user levels, and arguably gives rise to circumstances where users may be judged on the basis of how well they comply with the dominant narratives of institutional psychiatry (Newman et al, 2015;Stacey and Stickley, 2012). Thus, users can be perceived as being either too dependent or non-compliant, lacking in insight through rejection of a diagnosis or too reliant on it and avoidant of life responsibilities.…”

“…Reflecting monologic rather than dialogic organizational cultural styles in many mental health services, and a corresponding lack of collaborative care planning, people are often told what their problems are. In the absence of their involvement in discussions, or their agreement about how accurate this information feels to them, this can threaten relationships and trust between users and mental health workers, and the recovery process (Grant and Leigh-Phippard, 2014;Grant et al, 2015;Newman et al, 2015).…”

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“…The relationship between service users and healthcare professionals emerged as important for planning care and interactions. The main finding from this review is whilst people may express satisfaction with mental health services; there are issues around poor communication, service user involvement, decision making and limited treatment choice (Newman et al 2015).…”

“…This experience was drawn from a research study which explored how service users and healthcare professionals built relationships and communicated with each other. The rational for the study arose from an integrative literature review which explored service users' experience of mental health services (Newman et al 2015). The relationship between service users and healthcare professionals emerged as important for planning care and interactions.…”