Quality assessment of mental health rehabilitation services

Abstract

ObjectivesProviding good quality mental health care is vital to achieve better outcomes but service quality is a complex, multidimensional construct that extends beyond the delivery of specific evidence based treatments and interventions. This makes it difficult to operationalize and measure, particularly at the international level where different socioeconomic and political contexts impact. Mental health rehabilitation services focus on people with severe and complex psychosis. This group are one of the most socially excluded in society and are vulnerable to exploitation and abuse. They are also, be definition, difficult to treat and, historically, have often been institutionalised in hospital or community facilities.AimsThis presentation will report on the development and application of an internationally validated quality assessment tool for longer term mental health care facilities, the Quality Indicator for Rehabilitative Care (QuIRC).MethodsThe content of the QuIRC was derived from a systematic literature review, international Delphi exercise and review of care standards in ten European countries. Its psychometric properties were assessed in over 200 longer-term mental health facilities across Europe involving validation with over 1750 service users. It has subsequently been used in a national programme of research into inpatient mental health rehabilitation services in England which will also be briefly described.ResultsThe QuIRC has excellent inter-rater reliability and validity. Specific aspects of care assessed by the QuIRC have been found to be associated with successful community discharge from inpatient mental health rehabilitation services.ConclusionsThe QuIRC is a free to use, standardised and validated on-line international quality assessment benchmarking and research tool, available in ten European languages.Disclosure of interestThe author has not supplied his declaration of competing interest.