Quality of Care in Psychosis and Bipolar Disorder From the Service User Perspective
Abstract
According to the recovery model of mental health care, service development should incorporate the expert knowledge of service users. To date, there has been limited research into conceptualizations of mental health care quality among services users diagnosed with bipolar disorder or psychosis. To investigate service user perspectives on quality of care, we conducted six focus groups (N = 29) with inpatients and outpatients of an independent Irish mental health service. We undertook an inductive thematic analysis of the data. Participants identified proactive staff, meaningful and warm staff-patient interactions, and safety and sociability in the inpatient environment as components of good quality mental health care. Participants also discussed how the implementation of best practice guidelines does not necessarily improve quality of care from the service user perspective. This and similar qualitative research should be used to inform service development and the creation of evaluation instruments compatible with the recovery model.
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When staff were seen as unapproachable and showing little interest in patients, there was a negative impact on patients.
“The data also indicates that where staff were seen to be unap proachable, showing little interest in patients there was a negative impact on patients:”
From A qualitative synthesis of patients' experiences of re-traumatization in acute mental health inpatient settings (2023) · cites this paper as Skelly et al., 2013
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Methods for the thematic synthesis of qualitative research in systematic reviews
Thomas, J., & Harden, A. (2008) · BMC Medical Research Methodology · doi:10.1186/1471-2288-8-45 · Cited by 9,312 · see citing works
Discovering the Neural Basis of Human Social Anxiety: A Diagnostic and Therapeutic Imperative
Charney, D. S. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.1.1 · Cited by 1,428 · see citing works
Gilburt, H., Rose, D., & Slade, M. (2008) · BMC Health Services Research · doi:10.1186/1472-6963-8-92 · Cited by 396 · see citing works
The rediscovery of recovery: open to all
Roberts, G., & Wolfson, P. (2004) · Advances in Psychiatric Treatment · doi:10.1192/apt.10.1.37 · Cited by 326 · see citing works
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Vandyk, A. D., Young, L., MacPhee, C., & Gillis, K. A. (2017) · Qualitative Health Research · doi:10.1177/1049732317746382 · Cited by 78 · see citing works
Hennessy, B., Hunter, A., & Grealish, A. (2023) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12889 · Cited by 61 · see citing works
Pahwa, R., Smith, M. E., Yuan, Y., & Padgett, D. K. (2018) · Qualitative Health Research · doi:10.1177/1049732318814250 · Cited by 42 · see citing works
Self-Management and Bipolar Disorder–A Clinician’s Guide to the Literature 2011-2014
Janney, C. A., Bauer, M. S., & Kilbourne, A. M. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0485-5 · Cited by 39 · see citing works
Başkaya, E., & Demi̇r, S. (2022) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2022.12.007 · Cited by 44 · see citing works
Maassen, E., Regeer, B., Regeer, E. J., Bunders, J., & Kupka, R. (2018) · International Journal of Bipolar Disorders · doi:10.1186/s40345-018-0131-y · Cited by 29 · see citing works
Translating big data to better treatment in bipolar disorder - a manifesto for coordinated action
Manchia, M., Vieta, E., Smeland, O. B., Altimus, C. M., Bechdolf, A., Bellivier, F., Bergink, V., Fagiolini, A. M., Geddes, J. R., Hájek, T., et al. (2020) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2020.05.006 · Cited by 21 · see citing works
Simpson, A., Coffey, M., Hannigan, B., Barlow, S. H., Cohen, R., Jones, A., Faulkner, A., Thornton, A., Všetečková, J., Haddad, M., et al. (2017) · Health Services and Delivery Research · doi:10.3310/hsdr05260 · Cited by 15 · see citing works
“Consultation with service users may have revealed patient anxiety linked to involvement in treatment conferences, as identified by others.(131,132) Outcomes (satisfaction, quality of life, hope, therapeutic relationship, perceived coercion and attitude towards and self-evaluation of recovery) were compared pre (n = 34…”
BackgroundHaitana, T., Pitama, S. G., Cormack, D. M., Clark, M. T. R., & Lacey, C. J. (2021) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674211031490 · Cited by 14 · see citing works
“Clinician beliefs and behaviours contribute to health inequities, with cultural competence skills and cultural safety interventions required to support clinicians to work effectively with Indigenous and minoritised ethnic groups (Anderson et al., 2016; Betancourt et al., 2003, 2014; Medical Council of New Zealand, 201…”
BackgroundAghababaie-babaki, P., Malekpour, M., Mohammadi, E., Moghaddam, S. S., Rashidi, M., Ghanbari, A., Heidari‐Foroozan, M., Esfahani, Z., Fateh, S. M., Hajebi, A., et al. (2023) · International Journal of Social Psychiatry · doi:10.1177/00207640231182358 · Cited by 13 · see citing works
“Few studies have been conducted to evaluate the quality of care delivered to BD patients with geographic limitations and focus on a particular group of patients (Skelly et al., 2013; Unützer et al., 2000).”
BackgroundSEQUenCE: a service user-centred quality of care instrument for mental health services
Hester, L., O’Doherty, L., Schnittger, R. I. B., Skelly, N., Donnell, M. O., Butterly, L., Browne, R. C., Frorath, C., Morgan, C., McLoughlin, D. M., et al. (2015) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzv043 · Cited by 8 · see citing works
“These findings are described in full in a previous paper [22].”
BackgroundMethodSelf-citationBohan, J. K., Nielsen, M., Watter, K., & Kennedy, A. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2070222 · Cited by 8 · see citing works
“This provided investigator triangulation (Patton, 2015) across data collection, which has been used as a strategy to reduce individual researcher bias (Langford et al., 2018; Skelly et al., 2013) and to allow for different perspectives on the data (Jordan et al., 2013).”
MethodYoung patients’ views about provided psychiatric care
Malmström, E., Hörberg, N., Kouros, I., Haglund, K., & Ramklint, M. (2016) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2016.1176251 · Cited by 7 · see citing works
“In line with previous studies, patients reported being discouraged by the lack of respect or interest from the healthcare professionals (15,16,33,34), i.”
BackgroundPatterson, S., Bellair, R., Jeffrey, S., & Ward, W. K. (2017) · doi:10.15761/mhar.1000149 · Cited by 5
“Studies repeatedly highlight the value patients place on compassionate, respectful therapeutic engagement and feeling cared for as a whole person, with a life story, rather than a collection of symptoms [10-12].”
BackgroundResultVallarino, M., Rapisarda, F., Scott, J. L., Vecchi, T., Barbato, A., & D’Avanzo, B. (2018) · Community Mental Health Journal · doi:10.1007/s10597-018-0311-3 · Cited by 10 · see citing works
Shared Dilemmas in the Management of Bipolar Disorder
Wharne, S. (2016) · Journal of Humanistic Psychology · doi:10.1177/0022167815585912 · Cited by 4 · see citing works
Goulding, A., Wiktorsson, S., Allerby, K., Ali, L., & Wærn, M. (2025) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2437429 · Cited by 2 · see citing works
“In previous studies, service users stress the importance of a safe inpatient environment (Skelly et al., 2013; Stenhouse, 2013).”
The Changing Care of Older Adults With Bipolar Disorder: A Narrative Analysis
Warner, A., Palmier‐Claus, J. E., Holland, C., Tyler, E., Rhodes, V., Settle, G., & Lobban, F. A. (2024) · Qualitative Health Research · doi:10.1177/10497323241263043 · Cited by 2 · see citing works
“Existing qualitative research has identi fi ed that individuals with bipolar disorder value care that involves proactive staff, meaningful connections with professionals, and feelings of safety and sociability (Skelly et al., 2013).”
Romano, E., Ma, R., Sala, G., Ashworth, M. J., Perera, G., Stewart, R. J., & Stubbs, B. (2025) · PLOS mental health. · doi:10.1371/journal.pmen.0000185
“This is encouraging, as previous literature has reported how people with psychosis report quality of care can be inconsistent for them [33,34].”
- Authors
- Skelly, N., Schnittger, R. I., Butterly, L., Frorath, C., Morgan, C., McLoughlin, D. M., & Fearon, P.
- Affiliations
- St. Patrick's Hospital (IE)
- King's College London (GB)
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2013-10-25
- Volume
- 23
- Issue
- 12
- Pages
- 1672-1685
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- OpenAlex
- W2161150641
- Cited by
- 19
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 1
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Qualitative Health Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Health Research Board
- Mental Health Commission
- Topics
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- mental health care quality, psychosis, bipolar disorder, service user perspectives, recovery model, staff-patient interaction, inpatient care, best practice guidelines, service development, mental health services evaluation
- MeSH terms
- Adult, Aged, Bipolar Disorder, Female, Humans, Ireland, Male, Mental Health Services, Middle Aged, Psychotic Disorders, Quality of Health Care, Patient Satisfaction, Focus Groups
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