Stages

In achieving these aims, we will conduct our study in two stages:

Stage 1: We will perform a thorough literature review of high quality studies relating to indicators of outcome for both disorders. We will also conduct a series of focus groups of people with these two disorders who attend our services in order to identify what components they consider most important in good QoC. These will be combined into a preliminary QoC instrument which we will then refine and thoroughly field test in order to establish its validity and user-friendliness.

Stage 2: We will identify and recruit 150 volunteers (75 bipolar; 75 schizophrenia) who attended our services 2-3 years previously and interview them using the new instrument. In addition we will collect data using well-validated instruments on satisfaction with services, engagement with services, quality of life, global assessment of functioning, course of illness and level of disability. In doing this, we will address three hypotheses: 1) there will be few differences in service-user-rated items for Quality of Care between bipolar disorder and schizophrenia; 2) outcome will be positively correlated with quality of care in both groups; 3) service-user-rated items for quality of care will best predict social and functional outcome, whereas clinically rated items will best predict symptomatic and clinical course outcome in both groups.

We are employing 2 full time research assistants and 1 part time user researcher. Service User and stakeholder involvement will occur during the entire period of the study. In doing this, we hope to produce an instrument which can be used to measure QoC in Irish mental health care settings, and which incorporates service users’ priorities.