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. 2020 Jun;23(3):549-561.
doi: 10.1111/hex.13025. Epub 2020 Feb 11.

A qualitative exploration of mental health service user and carer perspectives on safety issues in UK mental health services

Kathryn Berzins  1 , John Baker  1 , Gemma Louch  2 , Abigail Albutt  2
Affiliations

A qualitative exploration of mental health service user and carer perspectives on safety issues in UK mental health services

Kathryn Berzins et al. Health Expect. 2020 Jun.

Abstract

Background: Service user and carer perspectives on safety issues in mental health services are not well known and may be important in preventing and reducing harm. The development of the Yorkshire Contributory Factors Framework-Mental Health (YCFF-MH) provides a broad structure within which to explore these perspectives.

Objective: To explore what service users of mental health services and their carers consider to be safety issues.

Design, setting and participants: Qualitative interviews with 13 service users and 7 carers in the UK. Participants were asked about their experiences and perceptions of safety within mental health services. Perceived safety issues were identified using framework analysis, guided by the YCFF-MH.

Results: Service users and carers identified a broad range of safety issues. These were categorized under 'safety culture' and included psychological concepts of safety and raising concerns; 'social environment' involved threatened violence and sexual abuse; 'individual service user and staff factors' dominated by not being listened to; 'management of staff and staffing levels' resulting in poor continuity of care; and 'service process' typified by difficulty accessing services during a crisis. Several examples of 'active failures' were also described.

Discussion and conclusions: Safety issues appear broader than those recorded and reported by health services and inspectorates. Many safety issues have also been identified in other care settings supporting the notion that there are overlaps between service users and carers' perspectives of safety in mental health services and those of users in other settings. Areas for further research are suggested.

Keywords: caregivers; health services research; mental health services; patient safety.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Figure 1
Figure 1
Yorkshire Contributory Factors Framework—Mental Health
Figure 2
Figure 2
Yorkshire Contributory Factors framework—Mental Health showing factors and subthemes most frequently identified in service user and carer interviews
See this image and copyright information in PMC

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