Service user experiences of mental health assessments: a systematic review and thematic synthesis of qualitative literature

Abstract

Background

Successive governments have placed service users’ experiences at the heart of mental health services delivery and development. However, little is known about service users’ experiences of assessments and there is some evidence that assessments can cause harm.

Aims

To synthesise the qualitative literature on service users’ experiences of undergoing mental health service assessments.

Methods

Literature was systematically searched, screened and extracted, following PRISMA guidelines. Several search strategies were employed, including electronic database searches, handsearching, and forward and backward citation tracking, to identify literature which contained data on service users’ experiences of mental health assessments. Thematic synthesis was used to derive a set of themes underpinning these experiences.

Results

Of the 10,137 references screened, 47 were identified as relevant to the review. Two main themes were identified: the importance of humanising assessment processes and experiences of service user agency, with each theme containing four sub-themes.

Conclusions

Findings highlight key factors determining service user experience. We identify key practice implications, contextualised within the literature on trauma-informed approaches and conclude that trauma-informed approaches may aid understanding and improvement of people’s assessment experiences. Further research into the experiences of people from Black and minority ethnic communities is indicated.

Keywords:

• Assessments
• service user experience
• qualitative
• systematic review
• thematic synthesis

Disclosure statement

The authors have no competing interests to declare.

Additional information

Funding

Angela Sweeney was funded by a National Institute for Health Research Post-Doctoral Fellowship. This paper presents independent research funded by the National Institute for Health Research (NIHR). Angela Sweeney would also like to acknowledge the support of the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.