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Understanding complexity in psychological services: A modified Delphi study.

Jenny Strachan1, Greg Halliday2, Ellie Caldwell3

  • 1West Lothian Psychological Therapies Service, NHS Lothian, St John's Hospital, Livingston, UK.

Journal of Evaluation in Clinical Practice
|June 15, 2022
PubMed
Summary

Applied psychologists reached a consensus on 13 key factors defining patient complexity in mental health services. This shared understanding of case complexity is crucial for improving psychological service provision.

Keywords:
clinical judgementcomplexitydefinitionframework developmentoperationalisingpsychological

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Area of Science:

  • Psychology
  • Mental Health Services Research

Background:

  • Patient complexity is a widely recognized concept in mental health services.
  • A lack of methodologically robust definitions has hindered consistent application.
  • This study addresses the need for a consensus on factors contributing to patient complexity.

Purpose of the Study:

  • To establish a consensus on factors contributing to patient complexity in adult psychological services.
  • To utilize Delphi methodology for expert consensus building.

Main Methods:

  • A three-round modified Delphi study was conducted with applied psychologists in the UK National Health Service.
  • Qualitative data on complexity factors were collected and thematically analyzed.
  • Quantitative ratings (Likert scales) assessed the centrality of identified themes.

Main Results:

  • A high degree of consensus was achieved on 13 factors contributing to patient/case complexity.
  • These factors include mental health status, functioning, engagement, history, and socioeconomic elements.
  • All identified factors were rated as central to assessing patient complexity.

Conclusions:

  • Applied psychologists share a common understanding of patient complexity.
  • Recommendations are made for further research to validate and apply this empirically derived framework.
  • The findings support the development of standardized complexity assessment tools in mental health.