Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses

Abstract

Purpose Our study investigated quality of life (QoL) in patients with severe or non-severe mental illness diagnoses (SMI and non-SMI) and the association between QoL and service satisfaction measured as patients’ perception of continuity of care (CoC), therapeutic relationship, and unmet service needs. Methods We conducted a national cross-sectional survey among 3836 mental health outpatients, of whom 1327 (34.6%) responded. We assessed QoL with the Manchester Short Assessment of Quality of Life (MANSA), CoC with the CONTINUUM, the therapeutic relationship with the Therapeutic Relationship in Community Mental Health Care (STAR-P) and developed a simple scale to measure unmet service needs. Results Outpatients with SMI ( n = 155) reported significantly better QoL than those with non-SMI ( n = 835) ( p = 0.003). In both groups, QoL was positively associated with cohabitation ( p = 0.007 for non-SMI and p = 0.022 for SMI), good contact with family and friends ( p < 0.001 for both) and positive ratings of CoC ( p < 0.001 for non-SMI and p = 0.008 for SMI). A positive association between QoL and therapeutic relationship ( p = 0.001) and a negative association between QoL and unmet needs for treatment ( p = 0.009) and activity ( p = 0.005) was only found in the non-SMI group. Conclusion Our study highlights the important differences between those with SMI and those with non-SMI in their reported QoL and in the relationship between QoL and service satisfaction, with only non-SMI patients’ QoL influenced by the therapeutic relationship and unmet needs for treatment and activity. It also shows the importance of continuity of care and social factors for good QoL for both groups.

Routine measurement of satisfaction with life and treatment aspects in mental health patients – the DIALOG scale in East London

“…This study adds to this known literature by exploring more clinical and service characteristics as opposed to individual factors. However, from the available clinical and demographic variables findings were in line with previous research, for example, we found higher satisfaction with life aspects in patients with psychotic disorders compared to mood or neurotic diagnoses [ 25 – 28 ]. Results from experimental studies have suggested that this is because affective states inform and direct judgements on satisfaction [ 29 ].…”

Sexuality in people living with a serious mental illness: A meta‐synthesis of qualitative evidence

“…Ådnanes et al. (2019) conducted a study that investigated satisfaction with the health services among people with a mental disorder, whether severe or non‐severe, among other aspects. The authors concluded that PLSMI had a worse connection with health services and that, to address this problem, these services needed to enhance the involvement of these people and their perspectives in the treatment process, since this increases not only their satisfaction, but also their quality of life.…”

Organization of Community Mental Health Services for Persons with a Severe Mental Illness and Comorbid Somatic Conditions: A Systematic Review on Somatic Outcomes and Health Related Quality of Life

“…A recent systematic review that evaluated self-management approaches in persons with a SMI included the evaluation of educational efforts in improving Quality of Life and Symptomatic outcomes and reported only a small effect of educational efforts on the perceived outcomes [ 64 ]. Additionally, several studies emphasize the importance of social contacts in continuity of care, and contacts with peer coaches provides a solid base for trustworthiness and commitment in people with a SMI [ 65 , 66 , 67 ].…”