Based on a survey of 449 service users and 201 care coordinators, researchers from City University London, Swansea and Cardiff universities identified key features in how community mental health care is planned and co-ordinated across the country.
The research took place in 6 sites – 4 in England and 2 in Wales – and also incorporated interviews with 117 managers, practitioners, service users and carers.
The project yielded three key findings:
• People using mental health services place substantial value on the quality of their relationships with staff in contrast to the value placed on written care plans, and although care plans are vital documents for managers and professionals, service users rarely return to them once they are complete
• Workers are acutely aware of the need to assess and manage risk, but do not routinely discuss this part of their work with service users or their families. "This is a missed opportunity to learn, and to share responsibility," the authors suggested
• Care coordinators see care plans as a useful record but also as an inflexible administrative burden that restricts time with service users.
Lead author Dr Michael Coffey, a specialist in research on the delivery and organisation of community mental health care at Swansea University, said: "Care planning and coordination is at the heart of effective mental health service delivery and is increasingly required to be personalised and focused on recovery, yet there has been little research conducted that explores these key aspects.
"A key feature of the study is that we worked with people who have experience of using mental health services as co-researchers on this project so that our research approach was meaningful to people who actually use services."
"This study has highlighted the need to find new ways to maximise therapeutic time with service users and staff at the same time seeking ways to reduce the administrative burden of preparing lengthy care documents.
"We also need to identify a method of addressing risk that is inclusive of service users and their families. Our collaboration is continuing to achieve exciting new evidence on how mental health services are experienced and delivered. Together with research projects we are currently running here at Swansea we hope to see this new evidence lead to positive changes for people with mental health problems."
He was joined in the project by researcher Professor Alan Simpson of City University London, and Drs Aled Jones and Ben Hannigan from Cardiff University, who contributed to the development of the idea, the design and the conduct of the study.
To read the study in full visit: www.journalslibrary.nihr.ac.uk/hsdr/volume-4/issue-5#abstract