title: Service users' experience of receiving bad news about their mental health.
abstract: BACKGROUND
  The breaking and receipt of bad news is little referred to in the mental health literature, particularly from a service user perspective.
  
  
  OBJECTIVE
  This project aimed to gain understanding of service users' experiences of receiving good and bad news from mental health professionals.
  
  
  METHODS
  Ten semi-structured interviews were conducted in which mental health service users recounted key moments when good or bad news was delivered to them and described the impact of that news on their psychological well being. Transcripts were analysed thematically.
  
  
  RESULTS
  The receiving of a diagnosis could be perceived as bad news or a cause of confusion where a diagnosis is changed. The importance of trust in professionals, the use of adequate time and information was considered important in buffering the impact of potentially bad news. The technique of comparing a mental disorder to a physical disorder is not always helpful.
  
  
  CONCLUSIONS
  The delivery of bad news in mental health is more complex than a "good or bad news" paradigm and it should be done in the context of a good therapeutic alliance. An individualized approach to delivering news about diagnosis is advocated.
authors.affiliation: International Centre for Nursing Ethics, Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey (project conducted when employed by Faculty of Health and Social Care Sciences, Kingston University and St George's University of London), Guilford, Surrey, UK. a.gallagher@surrey.ac.uk
authors.forename: Ann
authors.initials: A
authors.lastname: Gallagher
authors.forename: Anne
authors.initials: A
authors.lastname: Arber
authors.forename: Rob
authors.initials: R
authors.lastname: Chaplin
authors.forename: Alan
authors.initials: A
authors.lastname: Quirk
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003221:Confusion; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008603:Mental Health; D008875:Middle Aged; D010817:Physician-Patient Relations; D013997:Time Factors; D014342:Truth Disclosure