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Experiences of Mental Health Consumers : an Exploratory Qualitative Study of Expectations and Perceptions of Mental Health Services in Western Australia

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Experiences of Mental Health Consumers : an Exploratory Qualitative Study of Expectations and Perceptions of Mental Health Services in Western Australia Edith Cowan University Research Online Theses : Honours Theses 2000 Experiences of Mental Health Consumers : An Exploratory Qualitative Study of Expectations and Perceptions of Mental Health Services in Western Australia Dawn Anne Barrett Edith Cowan University Follow this and additional works at: https://ro.ecu.edu.au/theses_hons Part of the Other Mental and Social Health Commons Recommended Citation Barrett, D. A. (2000). Experiences of Mental Health Consumers : An Exploratory Qualitative Study of Expectations and Perceptions of Mental Health Services in Western Australia. https://ro.ecu.edu.au/ theses_hons/866 This Thesis is posted at Research Online. https://ro.ecu.edu.au/theses_hons/866 Experiences of Mental Health Consumers: An Exploratory Qualitative Study of Expectations and Perceptions of Mental Health Services in Western Australia EDITH COWAN UNtVERSITY LIBRARY By Dawn Anne Barrett A Report Submitted in Partial Fulfilment of the Requirements forthe Award of Bachelor of Arts (Psychology) Honours Faculty of Community Studies, Education and Social Studies Edith Cowan University October, 2000 DECLARATION "I declare that this written assignment is my own work and does not include: (i) material from published sources used without proper acknowledgement; or (ii) material copied from the work of other students". Signature: - Edith Cowan University Copyright Warning You may print or download ONE copy of this document for the purpose of your own research or study. The University does not authorize you to copy, communicate or otherwise make available electronically to any other person any copyright material contained on this site. You are reminded of the following: Copyright owners are entitled to take legal action against persons who infringe their copyright. A reproduction of material that is protected by copyright may be a copyright infringement. Where the reproduction of such material is done without attribution of authorship, with false attribution of authorship or the authorship is treated in a derogatory manner, this may be a breach of the author’s moral rights contained in Part IX of the Copyright Act 1968 (Cth). Courts have the power to impose a wide range of civil and criminal sanctions for infringement of copyright, infringement of moral rights and other offences under the Copyright Act 1968 (Cth). Higher penalties may apply, and higher damages may be awarded, for offences and infringements involving the conversion of material into digital or electronic form. Experiences of mental health consumers ii Experiences of Mental Health Consumers: An Exploratory Qualitative Study of Expectations and Perceptions of Mental Health Services in WesternAustralia Abstract The National Mental Health Strategy was launched in 1992 and endorsed consumer­ provider collaboration as an integral part of mental health service delivery in Australia. Feedback on services is generally elicited through evaluation of existing services. Rather than being an evaluative study of existing services, this qualitative project explored the experience of being a mental health consumer within the framework of the consumer's expectations and perceptions of service delivery in WesternAustralia. One male and seven females, aged between 22-55 participated in the study. Several themes and sub-themes under the broad headings of Expectations, Experiences, Perceptions emerged. The themes highlighted consumers had no expectations of mental health services. However, management of illness and staff interactions produced a psychological response. For those who experienced negative interactions with stafffear was a dominant psychological response which changed over time fromillness-related distress to fearof re-hospitalisation. All consumers reported an over-reliance on the use of medication and provided wider explanations for their episode of illness. A fourthcategory Reflective Comments, highlighted the inadequacies of the present services and the need for integrated biopsychosocial approaches. This small-scale study promotes a wider inquiry into the experience of being a mental health consumer in WesternAustralia. In particular, the differences in the experiences of private and public patients warrant further investigation. Author: Dawn Anne Barrett Supervisor: Dr Lynne Cohen Submitted: October, 2000 Experiences of mental health consumers iii Declaration I certify that this thesis does not incorporate, without acknowledgement, any material previously submitted for a degree or diploma in any institute of higher education and that, to the best of my knowledge and belief, it does not contain any material previously published or written by another person except where due referenceis made in the text. Signature: USE OF THESIS The Use of Thesis statement is not included in this version of the thesis. Experiences of mental health consumers v Acknowledgements For a project such as this, I am indebted to many people fortheir co-operation, support and guidance and take this opportunity to acknowledge them. For not only accepting me as a student, but also accepting the enthusiasm that accompanied the project, I would like to thank and acknowledge my supervisor, Dr Lynne Cohen. For the co-operation and support received, I thank members of mental health consumer groups in WesternAustralia, mental health consumers in the community and mental health professionals. Regrettably, due to the nature of this project I am unable to name them individually. Unlike learning,my writing is oftendone in isolation. For providing me with quality time, I thank my creative children, Sarah and Tim. And, last but not least, despite the nature of the experiences, forsharing them generously with humour and hope, I thank the participants of this study. As my educators they provided me with a rich learning environment forwhich I am deeply appreciative. Experiences of mental health consumers vi Table of Contents Introduction Background 1 Mental health in WesternAustralia 3 Summary comments on Australian mental health legislation 4 What is mental illness 5 The patient's voice 6 Contemporary perspectives on mental health consumers' views 10 Internationalstudies 11 Qualitative studies in Australia 14 Summary comments on international and Australian studies 15 A conceptual framework 16 Methodological approach 18 Definitions 19 Aims of the study 22 Method 24 Recruitment of participants 24 Participants 24 Profile of participants 26 Protocol 34 Ethical considerations 34 Interviews 34 Analysis 35 Results 37 Expectations 41 Experiences 43 Perceptions 62 Reflectivecomments 73 Summary of results 81 Discussion 86 Expectations 86 Experiences 87 Perceptions 91 Strengths and limitations of the study 98 Concluding remarks 102 References 106 --- Experiences of mental health consumers vii LIST OF APPENDICES Appendix A Correspondence to mental health consumer agencies 113 Appendix B Advertisement forthe study 114 Appendix C Interview schedule (and probe questions) 115 Appendix D Letter of introduction 116 Appendix E Mental health resources 117 Appendix F Consent form 118 Appendix G Qualitative data fromtranscripts 119 Appendix H Excerpts from National Standards forMental Health Services and Recommendations fromthe Report of the National Inquiry into the Human Rights of People with Mental Illness 162 Experiences of mental health consumers viii FIGURES Figure 1 Conceptual frameworkfor expectations and perceptions of the process of 'being heard' by consumers of mental health services in Australia. (Adapted fromCalnan, 1988) 17 Figure 2 Utilization of private and public hospitals by Case Study 1-8 in metropolitan Perth and rural WesternAustralia since 1992. 25 Figure 3 Stages of analysis forqualitative data from Case Study 1-8 using a cross case approach. 38 Figure 4 Comparison between Case Study 4, 5 and 7 highlighting expectations, psychological responses, and perceptions of hospitalisation in WesternAustralia. 74 Figure 5 A conceptual framework indicating a 'revolving door' forpublic mental health consumers, following the experience of mental health services in WesternAustralia. 83 Figure 6 A conceptual frameworkindicating a revision in expectations forprivate mental health consumers, followingthe experience of mental health services in Western Australia. 84 Experiences of mental health consumers ix TABLES 1. Psychiatric diagnosis given to Case Study 1-8 on discharge fromhospital 26 2. List of Categories, Themes and Sub-themes emerging fromcontent analysis of transcripts from Case Study 1-8 exploring expectations and perceptions of mental health services in WesternAustralia 40 3. Themes and sub-themes generated by Case Study 1-8 indicating EXPECTATIONS of mental health services, prior to hospital admission 42 4. Themes and sub-themes generated by Case Study 1-8 indicating EXPERIENCES of psychiatric hospitalization in WesternAustralia 44 5. Themes and sub-themes generated by Case Study 1-8 indicating PERCEPTIONS of mental health services followinghospitalization in WesternAustralia 63 6. Themes and sub-themes generated by Case Study 1-8 indicating REFLECTIVE COMMENTS about mental health services in WesternAustralia 75 Experiences of mental health consumers Introduction Background Lifetimeprevalence and incidence rates estimate one in fiveAustralians will experience some formof mental health disorder (Burdekin, 1993). Although most are expected to recover, it is further estimated only 3% of these individuals will seek specialist mental health services (Burdekin, 1993). Driven by the paucity of epidemiological research
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