Phoebe Averill

Patient safety incidents are a leading cause of death and disability worldwide. To date, the patient safety movement has primarily focused on the safety of physical healthcare services. As such, existing research into improving safety in mental healthcare is insufficient.

A small, yet accumulating body of work has explored what ‘safety’ looks like in the context of acute inpatient mental healthcare, providing valuable insights about the nature of the safety problems service users face within these settings.

However, the majority of mental healthcare encounters take place outside of hospital settings, and there is insufficient evidence about the types of safety and quality of care problems service users experience in community-based mental health services. Consequently, there is both a paucity of evidence about the principal risks to safety and lack of conceptual clarity over what constitutes a patient safety problem in this context.

This research programme will seek to supplement this evidence gap, by triangulating different sources of evidence to better understand the nature of the safety problems in community-based mental healthcare provision, and how the safety of care may be improved.

A systematic scoping review will be conducted to identify and synthesise existing literature on patient safety in community mental healthcare settings, as well as evidence for interventions to improve safety in this context.

Next, patient safety incidents reported to a national database by UK community mental health services will be analysed to provide a descriptive overview of safety problems, their contributory factors and the severity of harm caused. Subsequent in-depth analyses will examine the most commonly reported incident types in further detail.

A further contextualising study will involve in-depth interviews or focus groups with a purposive sample of service users, carers, and healthcare providers, to identify stakeholder perspectives on safety issues in community-based mental health services.

Current research activity

We are currently carrying out a study to find out about the safety problems people experience whilst accessing mental healthcare in adult community mental health services or primary care.

As part of this study, we will be carrying out interviews and focus groups with service users, carers and healthcare professionals or service managers with experience of community-based mental health services. These include primary care (e.g. treatment and monitoring of a mental health condition by a GP), or secondary care mental health services (e.g. outpatient support from Crisis Resolution and Home Treatment team, or a Community Mental Health Team).

This research will help to increase awareness of the types of safety issues service users experience, as well as gathering ideas about how to improve the safety of these services.

If you would like to hear more about this research, you can read more about the study here, or get in touch at phoebe.averill@kcl.ac.uk.

Please note: If you are a service user or carer, you will be offered a £15 voucher in return for your participation.

Phoebe gave a lightning talk about her research project at our 2022 annual event, THIS Space.