User and family-centred mental health services in Taiwan : Exploring the possibilities.

Global healthcare provision requires providers to supply efficient and cost-effective care, while continuously assessing user focused outcomes upon which to base subsequent improvements. However, the voice of the service user in mental health services is a relatively new concept in Taiwan. The aim of this research was to gain in-depth knowledge about the perspectives of users and providers of current Mental Health services in Taiwan and for these findings to inform recommendations for the development of user and family-centred mental health services in Taiwan.In order to achieve these aims, a multi-method approach was used. A satisfaction survey using the Verona Service Satisfaction Scale was administered. This scale was firstly translated and culturally adapted to produce a version in traditional Chinese (VSSS-TC) following protocols developed by the EPSILON Research Group. A pilot study procedure was carried out to test face and content validity. In depth interviews to elicit the experience of users, carers, providers and policy makers were also used. This research was conducted under ethical approval within two hospitals in Taiwan.A non-proportional sampling method was used for the survey data collection. The survey data were analysed by using SPSS software, and the results indicate that patients rate the highest level of satisfaction in 'Professional Skills and Behaviour Dimension' (m=3.82), whereas the lowest rate of satisfaction is 'Relative Involvement Dimension' (m=3.59). A purposive sampling approach was used to identify informants for qualitative interviews. The in-depth interviews with users, providers and three key informants were analysed by using a thematic analysis method. At the professional and policy making level, issues of stigmatisation, institutionalisation, and resource allocation, which influence service provision on different levels, as well as future expectations of mental health service in Taiwan were illuminated.Taking cultural characteristics and the perspective of users, providers and policy makers into consideration, recommendations are derived from the study findings. These include: (1) enhancement of community mental health care provision; (2) enabling the user's voice to be heard; and (3) reforming mental health education of the public and service providers. Since only two hospitals were involved, the results of this study are not claimed to be representative of the Mental Health System of Taiwan. However, this project was designed to elicit preliminary insights as a first step to understand issues concerning user involvement in Taiwan, and to provide a platform for future research.