Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales

Luther, Lauren; Fukui, Sadaaki; Garabrant, Jennifer M.; Rollins, Angela L.; Morse, Gary A.; Henry, Nancy; Shimp, Dawn; Gearhart, Timothy; Salyers, Michelle P.

doi:10.1007/s11414-018-9601-3

Cited by 19 publications

(24 citation statements)

References 64 publications

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“…Interventions to lessen provider stigma may consider how to address individual-level and organizational-level factors contributing to experiences of discordant care, while amplifying processes contributing to the experience of concordant care. This assertion is consistent with research showing that discordant care and stigma are associated with staff burnout (Charles & Bentley, 2018; Luther et al, 2019). Perceptions of stigma from professionals may reinforce internalized stigma and interfere with successful therapeutic interactions, negatively impacting the quality and effectiveness of mental health treatment (Wang, Link, Corrigan, Davidson, & Flanagan, 2018).…”

Section: Discussionsupporting

confidence: 90%

“…Quality of care provided to clients was assessed through two scales developed by Luther and colleagues (2019); the scales consisted of a 12-item person-centered, or concordant care, scale (e.g., “I feel I provided high quality services to clients”; α = .77) and a 10-item discordant care scale (e.g., “I took a long time responding to certain clients’ requests”; α = .82). Participants reported how frequently each item occurred in the past 6 months on a 6-point Likert-type scale, with higher scores on each scale reflecting greater concordant or discordant care.…”

Section: Methodsmentioning

confidence: 99%

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Mental health provider stigma, expectations for recovery, and perceived quality of care provided to persons with mental illness.

Dell¹,

Vidovic²,

Vaughn³

et al. 2021

Stigma and Health

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Mental health providers may stigmatize persons with mental illness through derogatory behaviors and negative beliefs. Provider stigma may negatively influence the perspectives of persons with mental illness on their own recovery process. It is unclear whether providers’ self-assessed stigma is associated with their perception of the quality of care they provide or how self-assessed stigma relates to providers’ own expectations for client recovery. The current study identifies the associations between provider stigma, perceived quality of care, and recovery expectations. A cross-sectional survey was used to collect data from a sample of primarily female (73.68%), White (73.68%), and master’s-level (56.58%) service providers and clinical supervisors at 2 community mental health agencies serving persons with serious mental illness (N = 76). Linear regression analysis was conducted to explore the relationship of discordant quality of care, concordant quality of care, and expectations for recovery to provider stigma and to test the interaction of recovery orientation with concordant and discordant care. Higher quality concordant care was moderately associated with lower stigma, whereas discordant care was strongly associated with greater stigma. The inverse relationship between recovery expectations and stigma was small and not statistically significant; however, the interaction of concordant care with recovery expectations accounted for additional variance in stigma scores. This study suggests that provider stigma and provider expectations for recovery are distinct constructs. Additionally, greater provider-reported mental health stigma may be associated with providers’ own negative perceptions of the quality of care they provide.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Mental health provider stigma, expectations for recovery, and perceived quality of care provided to persons with mental illness.

Dell¹,

Vidovic²,

Vaughn³

et al. 2021

Stigma and Health

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“…Sustainable change in Youth Care can only be achieved in cooperation with all parties involved, especially parents and their children [1]. Previous studies have shown that client perspectives demonstrate low convergence with quality indicators based on clinicans, research, and policy [2,3]. Clients often value functional outcomes in the context of everyday living and quality of life over control of their illness [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Clients often value functional outcomes in the context of everyday living and quality of life over control of their illness [ 4 5 ]. Moreover, incorporating client perspectives into clinical practice is associated with improved working alliance, increased satisfaction with services and autonomy support [ 3 ]. Thus, to provide integrated Youth Care responsive to the needs of families, it is essential to incorporate parental perspectives into clinical practice [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

et al. 2020

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Introduction: To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The aim of this study is to advance our understanding of key components of integrated Youth Care from a parental perspective. Methods: Semi-structured interviews were administered to 21 parents of children receiving Youth Care from integrated care teams in the Netherlands. Qualitative content analysis was conducted by means of a grounded theory approach following qualitative reporting guidelines. Results and discussion: Parental perspectives were clustered into six key components: a holistic, family-centred approach; addressing a broad range of needs in a timely manner; shared decision making; interprofessional collaboration; referral; and privacy. Parents emphasized the importance of a tailored, family-centred approach, addressing needs across several life domains, and active participation in their own care process. However, they simultaneously had somewhat opposing expectations regarding these key components, for example, concerning the changing roles of professionals and parents in shared decision making and the value of involving family members in a care process. Professionals should be aware of these opposing expectations by explicitly discussing mutual expectations and changing roles in decision making during a care process. To enable parents to make their own decisions, professionals should transparently propose different options for support guided by an up-to-date care plan.

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“…Researchers have developed a self-report quality of care scale, encompassing the IOM’s six domains of quality of care (Luther et al, 2019; Salyers et al, 2015). The revised scale revealed two subdomains of quality of care perceived by those who provide direct services to mental health service consumers (Luther et al, 2019). The two subdomains include person-centered care (capturing the two IOM’s quality of care domains: patient-centered and effective care) and discordant care (capturing the relative absence of four IOM’s quality of care domains: safe, equitable, efficient, and timely care).…”

mentioning

confidence: 99%

Factors that affect quality of care among mental health providers: Focusing on job stress and resources.

Fukui¹,

Salyers²,

Morse³

et al. 2021

Psychiatric Rehabilitation Journal

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Objective: High-quality, person-centered care is a priority for mental health services. The current study conducted secondary data analysis to examine the impact of job stress (i.e., interaction with high-risk consumer cases, increased caseload, emotional exhaustion) and resources (i.e., increased organizational and supervisory support, autonomy, role clarity) on providers' perceived quality of care. Methods: Data consisted of 145 direct care providers from an urban community mental health center. Structural equation modeling was used for testing the hierarchical regression model, sequentially adding job stress and resource variables in the prediction models for the quality of care (i.e., person-centered care, discordant care [conflict with consumers and tardiness]). Results: Person-centered care was positively associated with increased role clarity, organizational support, and larger caseload size, while a lower level of discordant care was associated with lower emotional exhaustion, smaller caseload size, less interaction with high-risk consumer cases, and with increased role clarity. Conclusions and Implications for Practice: Resources on the job may be particularly important for improved person-centered care, and lowering job stress may help reduce discordant care. The current study suggests the need for the mental health organizations to attend to both job stress and resources for providers to improve the quality of care. Impact and ImplicationsBoth lowering job stress and increasing job resources could impact different aspects of quality of care provided by mental health organizations and their workers. Lowering job stress may help reduce discordant care, and resources on the job may be important for improved person-centered care. Increasing job resources within the organization, such as increasing role clarity and organizational support, could be helpful, particularly for improving person-centered care.

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Measuring Quality of Care in Community Mental Health: Validation of Concordant Clinician and Client Quality-of-Care Scales

Cited by 19 publications

References 64 publications

Mental health provider stigma, expectations for recovery, and perceived quality of care provided to persons with mental illness.

Mental health provider stigma, expectations for recovery, and perceived quality of care provided to persons with mental illness.

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

Factors that affect quality of care among mental health providers: Focusing on job stress and resources.

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