User feedback in acute mental health care: why isn't it working?

For many years it has been assumed that people experiencing serious mental distress – sufficient to prompt an acute inpatient admission – are not capable of giving any meaningful feedback about the quality of their care.

But the recently published Euripides study, by a range of academics from the universities of Warwick, Sheffield, Birmingham and others, has found that in fact people using acute mental health services have plenty of insight to offer about their care.

The researchers also found that “like the quality of care itself, honest and meaningful feedback was likely to be given only when patients trusted staff.”

“Patients were wary of giving feedback before discharge for fear of persecution; this anxiety was shared by carers, who often felt excluded by staff,” says the study.

Although most trusts in England collect patient experience data, the research found that “few trusts had robust or extensive processes for analysing these data in any detail and we found little evidence that patient feedback led to service change.”

Patients were wary of giving feedback before discharge for fear of persecution

At Care Opinion we have been enabling users of mental health services to share their experience of care online since 2007. The issues identified by the Euripides study sound very familiar, and in our experience are not limited to mental health care settings – although the risk of negative feedback being seen as “a symptom of your illness” is perhaps distinctive of mental health care.

One of the features of online feedback via Care Opinion is that feedback authors remain anonymous. We hope that this reduces the fear and anxiety associated with sharing negative feedback about care.

One mental health trust in England, Nottinghamshire NHS Healthcare NHS Foundation Trust, has used Care Opinion very effectively over the past 10 years and now has 900 staff engaging with online feedback from service users and carers across a wide range of services, including acute and forensic mental health care.

However, the majority of mental health services across the UK are barely engaging with online feedback. Given the issues raised by the Euripides study, ignoring a safe, simple and effective way for people to give and receive feedback seems to me a terrible missed opportunity.

Discussing the study with its lead authors

Yesterday I was fortunate to have the opportunity to discuss the findings of the Euripides study with study lead authors Professor Scott Weich and Dr Sarah-Jane Fenton, along with Mark Brown, who writes and speaks on mental health issues, in an episode of Mental Health TV (#mhTV).

I have embedded a recording of the discussion here.

Mental Health TV is hosted by Unite / Mental Health Nurses Association, and co-hosted by Vanessa Garrity and Nicky Lambert.