User involvement in in-patient mental health services: operationalisation, empirical testing, and validation

Aims. This study presents development, empirical testing and validation of an instrument measuring service user involvement in in‐patient mental health from the mental health professionals’ perspective. Background. Service user involvement is high on the agenda in European mental health policies. In Norway, focus is on enhanced service user involvement at both the individual and organisational levels of in‐patient mental health services. Mental health professionals are in an important position to ensure opportunities for real user involvement in in‐patient mental health care. However, there is a need for more empirical knowledge on how mental health professionals attend to service user involvement. Design. Survey. Methods. A self‐report questionnaire was designed and administered to 121 mental health professionals, with 98 responses, working in a community‐based mental health centre in western Norway. Factor analysis procedures together with reliability testing were performed. Results. A 30‐items instrument was developed. The instrument contains four components/subscales: (1) Democratic patient involvement (mean score 3·74, Cronbach’s alpha 0·81), (2) Carer involvement (mean score 3·67, Cronbach’s alpha 0·82), (3) Assisted patient involvement (mean score 4·05, Cronbach’s alpha 0·78) and (4) Management support (mean score 4·10, Cronbach’s alpha 0·75). These subscales were found to be essential to service user involvement in the context of in‐patient mental health care. The total mean score for the instrument was 3·88, Cronbach’s alpha 0·88. Conclusion. Empirical testing of the instrument demonstrates that the measurement of mental health professionals’ perception of service user involvement has a reasonable level of construct validity and reliability. Relevance to clinical practice. We have developed a measurement instrument with items reflecting essential characteristics to user involvement in in‐patient mental health services. We believe that answering this questionnaire on the subject user involvement can act as one step towards enhancing awareness of this issue and to assess user‐oriented practices in treatment and services.