Medical records: Patient-held records in mental health

Richard Laugharne,Claire Henderson

doi:10.1192/pb.28.2.51

Abstract

‘But don't they get lost?’ This is usually the first comment made when the authors mention the use of patient-held records (PHRs) to colleagues. Nevertheless, PHRs have been used in mental health care as well as several other settings, including services for diabetes, cancer, maternity and child health. In some of these services, including mental health, PHRs have been an addition to clinician held standard notes, whereas in others the patient holds the only record for their care. The main purposes of introducing PHRs have been to empower patients with a sense of ownership of their care and to improve communication, between both patients and clinicians, as well as between different clinicians involved in that person's care (Laugharne & Stafford, 1996).

Highlights

‘But don’t they get lost?’ This is usually the first comment made when the authors mention the use of patient-held records (PHRs) to colleagues
Studies using PHRs in mental health were limited to patient and staff views in relatively small numbers of patients
Patients were positive about using a PHR, with usage being poorest among patients with paranoid ideation and those who did not accept they had a mental illness

Summary

RICHARD LAUGHARNE AND CLAIRE HENDERSON

‘But don’t they get lost?’ This is usually the first comment made when the authors mention the use of patient-held records (PHRs) to colleagues. PHRs have been used in mental health care as well as several other settings, including services for diabetes, cancer, maternity and child health. In some of these services, including mental health, PHRs have been an addition to clinician held standard notes, whereas in others the patient holds the only record for their care. An earlier review of literature on PHRs in mental health suggested that they are received positively by patients who use them, but few studies had evaluated their benefits (Laugharne & Stafford, 1996). Since a Cochrane systematic review (Henderson & Laugharne, 1999) and two randomised controlled trials (Warner et al, 2000; Lester et al, 2003) have been published and other trials of these records have evaluated their use in cancer care (Drury et al, 2000; Williams et al, 2001; Cornbleet et al, 2002; Lecouturier et al, 2002)

The evidence

Arguments for and against PHRs

Findings

Conclusions