A simple method of evaluating patients' perceptions of their treatment and care

Surveys of patient satisfaction have become commonplace in mental health services. However, questions about the appropriateness of "satisfaction" as a concept and its use as an approach to evaluating the quality of service provision remain as pertinent as ever. Although surveys of patients of mental health services routinely generate high levels of apparent satisfaction, noncompliance with treatment and medication continues to be a major difficulty in psychiatric care. To evaluate services properly, there is a need to access patients' dissatisfaction to determine whether it is a more valid indicator of quality of services and a better predictor of noncompliance. However, a method that is not time consuming and costly is also required. The authors introduce a new patient evaluation tool, "Your Treatment and Care," which requires patients to report on their direct experience of care according to a set of principles of good practice. The tool forms part of a broader package for obtaining patients' views of their own problems, need for care, quality of care received, and health and social outcomes. The authors also report the results of a survey using this tool. Responses of 75 patients of a psychiatric hospital in the United States are presented and compared with results from a similar survey in the United Kingdom. The comparisons show striking differences in patients' perceptions of quality of treatment and care, both within each population and across clinical contexts.