The continuum of client-centred practice in an acute psychiatric unit: A mixed method study of clients’ perceptions

Introduction: The increase of mental health problems calls attention to the need for a quality health care provision that meets the
complex needs of this group. The purpose of this study was to examine mental health clients’ perceptions of the care they received
in a hospital environment, focusing on how it was reflecting the main principles of client-centred practice.
Method: A mixed explanatory sequential design was used and data gathered with a self-report instrument and in-depth interviews. Thirty participants, discharging from a hospital ward, responded to the instrument and six others were interviewed after
being discharged.
Results: In general, participants evaluated the care they received as being rather client centred. Staff attitudes and support and
clients’ participation in decision-making and goal-setting were the two aspects that were most congruent with client-centred
practice, while staff interactions with significant others and the process and outcome of service were least congruent. Exploration
by interviewing revealed the complexity of client-centred practice and the influence of contextual factors.
Conclusion: Some aspects of client-centred mental health practice seem to be more easily achieved than others. At the contextual
level, professional culture, work habits and power structure may be some of the limiting factors.