Impact evaluation of an Independent Mental Health Advocacy (IMHA) service in a high secure hospital: a co-produced survey measuring self-reported changes to patient self-determination
Abstract
Purpose
The purpose of this paper is to measure any impact that IMHA support had on patient’s self-determination.
Design/methodology/approach
The study used a questionnaire design, co-produced with patients to ensure question relevance, accessibility and ease of use. The theoretical framework used by the study was Deci & Ryan’s empirically validated self-determination theory (SDT) as it is predictive, across cultures and domains (including healthcare), of psychological well-being and self-determined action following the satisfaction of three fundamental human needs for autonomy, competence and relatedness.
Findings
Following advocacy support, increased self-determination, was found in 70 percent of the patients surveyed. In this study, increased self-determination was inferred by patients’ subjective responses to survey questions which measured satisfaction with contextual aspects of autonomy, competence and relatedness. The extensive SDT research has identified that the satisfaction of these needs is essential for psychological well-being and a prerequisite for self-determined and motivated action. Research has also linked psychological needs fulfilment to the personal recovery journey for those diagnosed with a mental illness.
Originality/value
Although limited, qualitative research evidence has identified that IMHA support helps to empower their partners (referred to in the text as patients or patient partners) to be more self-determined. This is an important finding, particularly for those patient partners detained under the Mental Health Act, given the often disempowering and autonomy reducing nature of mental illness and the characteristics of detained environments. However, a gap in the literature exists for quantitative outcome data identifying the specific impact that IMHA support has for patients. Obtaining measurable outcome data which seek to understand how and why Independent Mental Health Advocacy support impacts its patient partners is essential for developing and validating outcome measures that can lead to best practice improvements in IMHA service delivery. Furthermore, this knowledge is pivotal in optimizing IMHA services’ potential for empowering patients and providing commissioners with the much-needed evidence for effective commissioning of such services.
Keywords
Acknowledgements
The author would like to thank the patients who co-produced and participated in this study. The NHS Commissioner of the advocacy service for his continued support, and the recovery-focused Broadmoor NHS Managers and ward staff who supported the work and facilitated access to patients. Special thanks goes to the five advocates who make up the Broadmoor advocacy team, whose hard work, patient-centred approach, empathy, persistence, dedication and resilience on the wards are nothing short of remarkable.
In October of this year, Prime Minister Theresa May announced a full review of the Mental Health Act (1983), which will report back at the end of 2018. Part of the background to the review of the Act, is that it should ensure the right of detained patients to treatment and support that is dignified and respectful of their autonomy as far as possible.
Citation
Eades, S. (2018), "Impact evaluation of an Independent Mental Health Advocacy (IMHA) service in a high secure hospital: a co-produced survey measuring self-reported changes to patient self-determination", Mental Health and Social Inclusion, Vol. 22 No. 1, pp. 53-60. https://doi.org/10.1108/MHSI-12-2017-0054
Publisher
:Emerald Publishing Limited
Copyright © 2018, Emerald Publishing Limited