Table 2 Service users’ experience of continuity. Themes represent continuums from good to poor continuity
From: Continuity of care as experienced by mental health service users - a qualitative study
Theme | Good continuity | Poor continuity | ||
|---|---|---|---|---|
Description | Subjective experience | Description | Subjective experience | |
Relationship | Trusting relationship with one or a few professional helpers over time | Mutual knowledge and respect Feelings of trust and safety Perceiving support as helpful | Frequent breaks with therapist or contact person(s) | Having to tell your personal story again and again is frustrating Having to relate to new persons provokes anxiety Feeling rejected Getting the impression that the professional helpers do not care Setback in terms of diagnostic evaluation and treatment |
Timeliness | Help when needed Not having to wait | Feelings of relief Avoid negative consequences of waiting too long | Being kept waiting Not knowing what is going to happen | Worrying about problems and upcoming contact with services Experiencing challenges with managing mental health and related problems Suffering and worsening of problems Risk of suicide |
Mutuality | All involved parties take initiatives Having an opportunity for contact whenever something comes up Having a say in decisions | Feeling that the professional helper is reliable and cares about you Feeling that you have a say in decisions | Always being the one who has to take the initiative in order to make things happen | Feelings of frustration and indifference, feeling that you have to ‘fight’ the system Feeling ignored because of professional helpers who do not get in touch |
Choice | Having the opportunity to choose among an array of options regarding where to be treated and what kind of support to get Having the opportunity to influence decisions Having the possibility of increasing personal continuity by making individual choices suited to your situation and context | Feeling that the situation is created according to your needs, both regarding treatment and practical aspects | Having no choice regarding decisions about where, when and how to get help No possibility of influencing decisions about contact persons, treatment and support Following the rules made by the system, for instance when being transferred from one service to another | Feeling ignored Feelings of indifference or opposition towards professional helpers, treatment and the system Starting to ignore the system and its rules |
Knowledge | Knowing about evaluations and future plans Getting information about scheduled meetings and support interventions well ahead of time Knowing who is communicating about you, and how and why | Understanding what is happening and what is going to happen Feeling more secure and being more secure Experiencing predictability in practical terms | Not being informed about what is happening, and why and how Not knowing how or whether the involved parties communicate about you or your situation | Feelings of confusion, distress and insecurity Feelings of tiredness and indifference |