Talking About Things Important to Me: Mental Health Consumers' Experiences of Consumer-Rated Measures.

Abstract

Since 2002, National Outcomes and Casemix Collection of clinician-rated and consumer-rated outcome measures has become part of routine care within Australian clinical mental health services, aiming to ensure that services understand, improve and are accountable for effectiveness of treatment and care provision. Consumer-rated outcome measures, implemented well, support basic human rights of consumers to be asked, heard and included equally in their own care. However, their use has lagged due to clinician inertia, uncertainty about their value to clinical care, assumptions about consumers' capacity to complete the measures and organisational cultural issues that have hampered more holistic assessment, consumer inclusion and care collaboration. Much is known about negative, largely tokenistic use of such measures, poor uptake and dominance of clinical approaches to measurement that privilege clinical expertise; however, little is known about consumers' positive experiences of using consumer-rated measures, Therefore, our aims were as follows: to seek the views and experiences of mental health consumers of using consumer-rated measures in their encounters with clinicians; to understand better whether there were benefits (and if so what) of consumer-rated measures being used in routine mental health practice; to understand how feedback on the use of consumer-rated measures can inform training for mental health staff; and to promote their wider use within mental health services. In-depth interviews conducted with 10 Australian mental health consumers used interview questions co-designed with lived experience and clinical advocates. Descriptive thematic analyses produced four themes emphasising consumers' preferences for completing the measures, the importance of explaining their purpose, how the process validated their feelings and was an opportunity for self-reflection, sense-making, trust-building, and transparency in the encounter and empowerment. This research offers recommendations about the value of effective implementation of consumer-rated measures.