Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
Mental Health Research Group, Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Health Expect. 2018 Jun;21(3):597-605. doi: 10.1111/hex.12650. Epub 2017 Nov 16.
It has been established that mental health-care planning does not adequately respond to the needs of those accessing services. Understanding the reasons for this and identifying whose needs care plans serve requires an exploration of the perspectives of service users, carers and professionals within the wider organizational context.
To explore the current operationalization of care planning and perceptions of its function within mental health services from the perspectives of multiple stakeholders.
Participants included 21 mental health professionals, 29 service users and 4 carers from seven Mental Health Trusts in England. All participants had experience of care planning processes within secondary mental health-care services.
Fifty-four semi-structured interviews were conducted with participants and analysed utilizing a qualitative framework approach.
Care plans and care planning were characterized by a failure to meet the complexity of mental health needs, and care planning processes were seen to prioritize organizational agendas and risk prevention which distanced care planning from the everyday lives of service users.
Care planning is recognized, embedded and well established in the practices of mental health professionals and service users. However, it is considered too superficial and mainly irrelevant to users for managing mental health in their everyday lives. Those responsible for the planning and delivery of mental health services should consider ways to increase the relevance of care planning to the everyday lives of service users including separating risk from holistic needs assessment, using support aids and utilizing a peer workforce in this regard.
心理健康护理计划未能充分满足服务使用者的需求，这一点已得到证实。要了解造成这种情况的原因，并确定护理计划服务于谁的需求，就需要在更广泛的组织背景下，探索服务使用者、照顾者和专业人员的观点。
从多个利益相关者的角度探讨心理健康服务中护理计划的当前运作情况及其功能的看法。
参与者包括英格兰七个心理健康信托基金的 21 名心理健康专业人员、29 名服务使用者和 4 名照顾者。所有参与者都有在二级精神卫生保健服务中参与护理计划过程的经验。
对参与者进行了 54 次半结构化访谈，并采用定性框架方法进行了分析。
护理计划和护理计划的特点是未能满足心理健康需求的复杂性，护理计划过程优先考虑组织议程和风险预防，这使得护理计划与服务使用者的日常生活脱节。
护理计划在精神卫生专业人员和服务使用者的实践中得到认可、嵌入和很好的确立。然而，它被认为过于肤浅，主要与用户无关，无法在日常生活中管理他们的心理健康。负责规划和提供心理健康服务的人员应考虑采取措施，增加护理计划对服务使用者日常生活的相关性，包括将风险与整体需求评估分开、使用支持辅助工具，并在这方面利用同行劳动力。
