Adult Mental Health Consumers' Interpretations and Uses of Feedback from a Standardized Mental Health Recovery Measure

Background and Purpose:

While research exists on practitioner and organizational uses of standardized outcomes information, little is known about how mental health consumers actually interpret and use such standardized feedback in their unique mental health recovery efforts. Understanding mental health consumers' perceptions and uses of feedback from standardized mental health recovery measures is crucial to creating a treatment feedback process that is useful and meaningful to consumers as well as service providers. The aim of this qualitative study is to describe how adult mental health consumers interpret and use information from a standardized mental health recovery measure in their respective mental health recovery efforts.

Methods

Data was collected through participant observation and tape-recorded, semi-structured interviews with a convenience sample of 17 adults living with a severe mental illness who had recently completed an annually administered mental health recovery measure at their respective provider agencies. Atlas.ti was used to manage and analyze data. Interviews were transcribed and uploaded into Atlas.ti. All transcriptions were initially line-by-line coded, and these line-by-line codes were then sorted into shared themes relating to consumers' understandings, experiences and uses of information generated through the measure. Thematic analysis continued until no new codes were being generated and all data were accounted for. Member checking was done via sharing analysis with participants, getting feedback, and making revisions to help ensure that analysis reflected participants' understandings and uses.

Results:

Analysis provided descriptive information about consumers' interpretations and uses of a standardized measure of mental health recovery. Significant aspects of these interpretations and uses included: (1) consumers viewed their responses to the outcomes measure questions as “me as a moment in time”, as opposed to a generalized measure of their functioning over the past year; (2) answering outcomes questions prompted introspection and increased self-awareness, e.g., “it got me to think about things I wouldn't normally think about”; (3) answering outcomes questions served to remind consumers of specific issues that they had not yet discussed with their workers, but felt they needed to; (4) the actual act of answering some outcomes questions could impact and change consumers' feelings for better or worse, likely impacting answers to subsequent questions; (5) feedback reports needed to have less numerical data and more graphical and narrative information; (6) consumers compared results reports for “fit” with their own self-perceptions of functioning; (7) the act of choosing to agree/disagree with feedback reports was empowering; (8) agreeing/disagreeing with results report prompted further introspection and raised self-awareness.

Conclusions and Implications

This study offers a description of mental health consumers' interpretations and applications of information from standardized recovery measure in their respective mental health recovery efforts. In an era where standardization of interventions and outcomes are increasing routinized in mental health service delivery, understanding and incorporating consumers' interpretations and uses of standardized feedback relating to their recovery will be ever more important in creating and/or maintaining consumer-driven mental health service systems. Funding for this research provided by the Ohio Department of Mental Health.