Defining continuity of care from the perspectives of mental health service users and professionals: An exploratory, comparative study

Angie Sweeney*, Jonathon Davies, Susan Mclaren, Margaret Whittock, Ferew Lemma, Ruth Belling, Sarah Clement, Tom Burns, Jocelyn Catty, Ian Rees Jones, Diana Rose, Til Wykes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)
194 Downloads (Pure)


Background: Continuity of care (COC) is central to the organization and delivery of mental health services. Traditional definitions have excluded service users, and this lack of involvement has been linked to poor conceptual clarity surrounding the term. Consequently, very little is known about the differences and similarities in the conceptualization of COC by mental health service users and professionals. Objective: To explore and compare mental health service users’ and professionals’ definitions of COC. Methods: Using an exploratory, qualitative design, five focus groups with 32 service users each met twice. Data were analysed thematically to generate a service user-defined model of COC. In a cross-sectional survey, health and social care professionals (n = 184) defined COC; responses were analysed thematically. Service user and professional definitions were conceptually mapped and compared to identify similarities and differences. Results: There was crossover between the service user and professional derived models of COC. Both contained temporal, quality, systemic, staff, hospital and needs-related elements of COC. Service users prioritized access, information, peer support and avoiding services; health professionals most frequently referred to staff, cross-sectional and temporal COC. Service users alone identified service avoidance, peer support and day centres as COC elements; professionals alone identified cross-sectional working. Conclusions: Important similarities and differences exist in service user and professional conceptualizations of COC. Further research is necessary to explore these differences, prior to integrating service user and professional perspectives in a validated COC framework which could enable the development and evaluation of interventions to improve COC, informing policy and practice.

Original languageEnglish
Pages (from-to)973-987
Number of pages15
JournalHealth expectations : an international journal of public participation in health care and health policy
Issue number4
Early online date29 Dec 2015
Publication statusPublished - 1 Aug 2016


  • Continuity of care
  • General adult psychiatry
  • Health professionals
  • Mental health services
  • Service users


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