Subject(s)
Mental Disorders/nursing , Occupational Diseases/nursing , Occupational Health Services , Rehabilitation, Vocational , Social Work, Psychiatric , Social Work , England , Humans , Mental Disorders/psychology , Mental Disorders/rehabilitation , Occupational Diseases/psychology , Occupational Diseases/rehabilitation , Personnel Selection , Rehabilitation, Vocational/psychology , Social Environment , Social SupportABSTRACT
BACKGROUND: User involvement in health services has been a priority for government since 1990. In mental health, concern has been expressed that involved service users (activists) are not representative of 'ordinary' patients. AIMS: (i) To investigate service users' perceptions of the outcomes of user involvement in two London boroughs. (ii) To determine whether the perceptions of outcomes differ between activists and non-activists. METHOD: The study was user-led. The user-researchers compiled a semi-structured interview schedule which they then administered to a sample of 40 people; 20 were defined as activists and 20 as non-activists. There were also 20 participants in each borough. RESULTS: Activists were aware of more user groups and forms of user involvement than non-activists. However, in terms of perceptions of the outcomes of user involvement, there was little difference between the activists and non-activists. DISCUSSION: There is very little extant work on the outcomes of user involvement in mental health services. This study examined this and, contrary to reservations often expressed, there was little difference between activists and non-activists. CONCLUSION: This is a pilot study. Further work should examine perceptions of the outcomes of user involvement by other stakeholders, for example, front-line workers, managers, carers and commissioners.
Subject(s)
Health Policy , Mental Disorders/rehabilitation , Mental Health Services , Patient Advocacy , Patient Participation , State Medicine , Adolescent , Adult , Aged , Bipolar Disorder/diagnosis , Bipolar Disorder/psychology , Bipolar Disorder/rehabilitation , Delivery of Health Care , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Depressive Disorder/rehabilitation , England , Female , Health Services Accessibility , Health Services Research , Humans , Interview, Psychological , Male , Mental Disorders/psychology , Middle Aged , Physician-Patient Relations , Quality of Health Care , Schizophrenia/diagnosis , Schizophrenia/rehabilitation , Schizophrenic Psychology , Young AdultABSTRACT
BACKGROUND: Electroconvulsive therapy (ECT) is a procedure that attracts special safeguards under common law for voluntary patients and under both current and proposed mental health legislation, for those receiving compulsory treatment. AIMS: To review patients' views on issues of information, consent and perceived coercion. METHOD: Seventeen papers and reports were identified that dealt with patients' views on information and consent in relation to ECT; 134 'testimonies' or first-hand accounts were identified. The papers and reports were subjected to a descriptive systematic review. The testimony data were analysed qualitatively. RESULTS: Approximately half the patients reported that they had received sufficient information about ECT and side-effects. Approximately a third did not feel they had freely consented to ECT even when they had signed a consent form. Clinician-led research evaluates these findings to mean that patients trust their doctors, whereas user-led work evaluates similar findings as showing inadequacies in informed consent. CONCLUSION: Neither current nor proposed safeguards for patients are sufficient to ensure informed consent with respect to ECT, at least in England and Wales.
Subject(s)
Electroconvulsive Therapy , Informed Consent , Mental Disorders/therapy , Patient Education as Topic , Electroconvulsive Therapy/adverse effects , England , Humans , Mental Disorders/psychology , WalesABSTRACT
OBJECTIVE: To ascertain patients' views on the benefits of and possible memory loss from electroconvulsive therapy. DESIGN: Descriptive systematic review. DATA SOURCES: Psychinfo, Medline, Web of Science, and Social Science Citation Index databases, and bibliographies. STUDY SELECTION: Articles with patients' views after treatment with electroconvulsive therapy. DATA EXTRACTION: 26 studies carried out by clinicians and nine reports of work undertaken by patients or with the collaboration of patients were identified; 16 studies investigated the perceived benefit of electroconvulsive therapy and seven met criteria for investigating memory loss. DATA SYNTHESIS: The studies showed heterogeneity. The methods used were associated with levels of perceived benefit. At least one third of patients reported persistent memory loss. CONCLUSIONS: The current statement for patients from the Royal College of Psychiatrists that over 80% of patients are satisfied with electroconvulsive therapy and that memory loss is not clinically important is unfounded.