The continuum of client-centred practice in an acute psychiatric unit: A mixed method study of clients’ perceptions

Abstract

Introduction

The increase of mental health problems calls attention to the need for a quality health care provision that meets the complex needs of this group. The purpose of this study was to examine mental health clients’ perceptions of the care they received in a hospital environment, focusing on how it was reflecting the main principles of client-centred practice.

Method

A mixed explanatory sequential design was used and data gathered with a self-report instrument and in-depth interviews. Thirty participants, discharging from a hospital ward, responded to the instrument and six others were interviewed after being discharged.

Results

In general, participants evaluated the care they received as being rather client centred. Staff attitudes and support and clients’ participation in decision-making and goal-setting were the two aspects that were most congruent with client-centred practice, while staff interactions with significant others and the process and outcome of service were least congruent. Exploration by interviewing revealed the complexity of client-centred practice and the influence of contextual factors.

Conclusion

Some aspects of client-centred mental health practice seem to be more easily achieved than others. At the contextual level, professional culture, work habits and power structure may be some of the limiting factors.