What does ‘safe care’ mean in the context of community-based mental health services? A qualitative exploration of the perspectives of service users, carers, and healthcare providers in England (11 September 2024)

Summary

This study examined how service users, carers, and healthcare providers conceptualise ‘patient safety’ in community-based mental healthcare.

Four key themes were developed, reflecting contrasting conceptualisations of safety in this care context, where participant thinking evolved throughout discussions.

• ‘Systemic inertia: threats to safety’ characterises the entrenched, systemic challenges which rendered participants powerless to advocate for or deliver safe care.
• ‘Managing the risks service users present’ equates ‘safe care’ to the mitigation of risks service users may pose to themselves or others when unwell, or risks from those around them.
• ‘More than responding to risks: everyone plays a role in creating safety’ recognises providers’ agency in causing or proactively preventing patient harm.
• ‘The goals of ‘safety’: our destination is not yet in sight’ positions safety as a work in progress, calling for ambitious safety agendas, giving primacy to goals which meaningfully improve service users’ lives.