Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study

Abstract

BackgroundContinuity of care (COC) is central to the organization and delivery of mental health services. Traditional definitions have excluded service users, and this lack of involvement has been linked to poor conceptual clarity surrounding the term. Consequently, very little is known about the differences and similarities in the conceptualization of COC by mental health service users and professionals.ObjectiveTo explore and compare mental health service users’ and professionals’ definitions of COC.MethodsUsing an exploratory, qualitative design, five focus groups with 32 service users each met twice. Data were analysed thematically to generate a service user‐defined model of COC. In a cross‐sectional survey, health and social care professionals (n = 184) defined COC; responses were analysed thematically. Service user and professional definitions were conceptually mapped and compared to identify similarities and differences.ResultsThere was crossover between the service user and professional derived models of COC. Both contained temporal, quality, systemic, staff, hospital and needs‐related elements of COC. Service users prioritized access, information, peer support and avoiding services; health professionals most frequently referred to staff, cross‐sectional and temporal COC. Service users alone identified service avoidance, peer support and day centres as COC elements; professionals alone identified cross‐sectional working.ConclusionsImportant similarities and differences exist in service user and professional conceptualizations of COC. Further research is necessary to explore these differences, prior to integrating service user and professional perspectives in a validated COC framework which could enable the development and evaluation of interventions to improve COC, informing policy and practice.

Social Networks and Social Interaction among People with Psychiatric Disabilities-Comparison of Users of Day Centres and Clubhouses

“…The DC users reported larger social networks, but did not experience better quality in their relationships than non-users with psychiatric disabilities (Argentzell, Leufstadius, & Eklund, 2013). Furthermore, the results of a British study showed that DCs met an important need for social contacts and enhanced continuity of the users' social context (Sweeney et al, 2016).…”

Concepts, models and measurement of continuity of care in mental health services: A systematic appraisal of the literature

“…Alongside the overarching dimension of experienced continuity, the two dimensions of cross‐boundary and longitudinal CoC may be considered to be key anchors of care continuity (Ware et al., ). Cross‐boundary continuity is defined as effective coordination of care between professionals and services involving good management of links between services, professionals and components of care (Adair et al., ; Sweeney et al., ; Uijen et al., ; Ware et al., ). Longitudinal continuity is defined as having care delivered by as few professionals as possible with minimal gaps in treatment (Burns et al., ; Ware et al., ).…”

“…The concept of ‘contextual continuity,’ defined as care which is sustained within a person's preferred social relationships in the community, is identified as a component of CoC in a number of studies in this review (see Table ; n = 5). The availability of day centres (Rose et al., ; Sweeney et al., ), supported housing (Burns et al., ; Ware et al., ), and peer support (Sweeney et al., ) are considered to be contributors to contextual continuity. Service users find the option of attending day centres a valuable contributor to their overall care according to two studies (Rose et al., ; Sweeney et al., ).…”

“…Characterizing the key features of a definition of CoC has proved challenging and a consensus on a systematic definition in mental health care has not been reached (Catty et al., ; Jones et al., ; Sweeney et al., ). Care continuity, it has been observed, is a concept which is often lauded but seldom defined (Burns et al., ; Crawford et al., ).…”

“…Sweeney et al. () observe that CoC definitions have been historically dominated by the ‘professional paradigm’ which prioritizes professionals’ perspectives. The alternative is the ‘perspectivist paradigm,’ which places the emphasis on service users’ views and experiences of health care.…”