Abstract
Background
National Health Service use the Community Mental Health Service User Questionnaire (NHS-CMH) to assess care quality. However, its reliability and internal validity is uncertain.
Aims
To test the NHS-CMH structure, reliability and item-level characteristics.
Methods
We used data from 11,373 participants who answered the 2017 NHS-CMH survey. First, we estimated the NHS-CMH structure using Exploratory Factor Analysis (EFA) in half of the dataset. Second, we tested the best EFA-derived model with Confirmatory Factor Analysis (CFA). We tested the internal validity, construct reliability (omega – ω), explained common variance of each factor (ECV), and item thresholds.
Results
EFA suggested a 4-factor solution. The structure derived from the EFA was confirmed, demonstrating good reliability for the four correlated dimensions: “Relationship with Staff” (ω = 0.952, ECV = 40.1%), “Organizing Care” (ω = 0.855, ECV = 21.4%), “Medication and Treatments” (ω = 0.837, ECV = 13.3%), and “Support and Well-being” (ω = 0.928, ECV = 25.3%). A second-order model with a high-order domain of “Quality of Care” is also supported.
Conclusions
The NHS-CMH can be used to reliably assess four user-informed dimensions of mental health care quality. This model offers an alternative for its current use (item-level and untested sum scores analysis).
Disclosure statement
All authors declare no known conflict of interests.
Data availability statement
The datasets were derived from sources in the public domain at https://beta.ukdataservice.ac.uk/datacatalogue/studies/study?id=8312#!/details. The code underlying the processing and analysis of the data included in this article are available in the online supplemental material and at 10.17605/OSF.IO/SBUP5.