Priorities of Staff and Service Users in Mental Health Assessment: A Q Methodological Study

Abstract

Service users’ first contact with UK National Health Service (NHS) mental health services has been shown to impact on treatment and outcomes. However, there is no consensus as to what constitutes Initial Assessment (IA) and there appear to be disparities between professionals’ and service users’ views. Using a Q methodology approach, the research aims to explore clinicians’ and service users’ views of IA within community mental health services. Four service user consultants and six clinicians completed a questionnaire to elicit views on the topic. In conjunction with a search of the literature on IA, this produced a set of fifty five statements derived by content analysis, which provided the basis of the Q sort. A sample of mental health professionals and services users (N = 21) completed the Q sort. Factor analysis identified four factors which represented the different points of view about IA. These were interpreted and named as “standardised and person-centred”, “efficiency of process”, “positive and self-contained relationship”, and; “supply vs. demand”. The findings highlighted differences in how participants viewed the clinician’s role, decision making, and topics discussed within IA. However, in contrast to previous research there were similarities across different professional groups and service users. The clinical impact of these findings is also explored.