What should inpatient psychological therapies be for? Qualitative views of service users on outcomes

Ceri Morgan; Lucy Clarkson; Rebecca Hiscocks; India Hopkins; Katherine Berry; Natasha Tyler; Lisa Wood; Pamela Jacobsen

doi:10.1111/hex.13889

What should inpatient psychological therapies be for? Qualitative views of service users on outcomes

Health Expect. 2023 Oct 12;27(1):e13889. doi: 10.1111/hex.13889. Online ahead of print.

Authors

Ceri Morgan¹, Lucy Clarkson¹, Rebecca Hiscocks¹, India Hopkins¹, Katherine Berry^{2

3

4}, Natasha Tyler⁵, Lisa Wood^{6

7}, Pamela Jacobsen¹

Affiliations

¹ Department of Psychology, University of Bath, Bath, UK.
² Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
³ Department of Research and Innovation, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
⁴ Rawnsley Building Manchester Royal Infirmary, Manchester, UK.
⁵ NIHR School for Primary Care Research, University of Manchester, Manchester, UK.
⁶ Division of Psychiatry, University College London, London, UK.
⁷ Research and Development Department, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford, UK.

Abstract

Background: There is limited research on what, when and how outcomes should be measured in psychological therapy trials in acute mental health inpatient wards.

Objectives: This study aimed to consider what outcomes service users think are important to measure.

Methods: This qualitative study explored the views of 14 participants, who had an inpatient admission within the last year, on outcomes of psychological therapies using semistructured interviews. Data were analysed using thematic analysis from a critical realist perspective with both inductive and deductive coding.

Results: The 126 outcomes that were important to participants were mapped onto an established taxonomy of outcomes across different health areas and the socioecological framework to consider the wider context and help summarise the outcomes. Most of the outcomes were mapped to the intrapersonal and interpersonal level. In addition to the outcome mapping, three themes were constructed from the qualitative data: (1) I am not a problem I am a person, (2) Feeling cared for and loved, (3) What does getting better look like.

Conclusions: Our results highlight the need for patient-reported outcomes which are cocreated with service users, disseminating research and training on preventing dehumanising experiences, enhancing psychological safety and therapeutic relationships and improving access to psychological therapy.

Patient or public contribution: The wider People with Personal Experience Involvement Committee at the University of Bath were consulted which included a focus group during the early planning stages. We also collaborated with a person with personal experience, at every stage of the research. This included developing our research question and aims, protocol, participant documents (e.g., information and debrief forms), advertisement and recruitment strategy, interview topic guide, the codes, the final themes and quotes and reviewing the manuscript. People with lived experience of being admitted to an acute mental health inpatient ward participated in our study.

Keywords: acute; inpatient; mental health; outcomes; patient-reported outcomes; psychological therapies; service users; views.

Grants and funding

University of Bath