title: Defining continuity of care from the perspectives of mental health service users and professionals: an exploratory, comparative study.
abstract: 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.
  
  
  
  To explore and compare mental health service users' and professionals' definitions of COC.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Population Health Institute, St George's University of London, London, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Sweeney
authors.affiliation: Department of Child, Family and Community Studies, Douglas College, British Columbia, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Davies
authors.affiliation: Faculty of Health and Social Care, London South Bank University, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: McLaren
authors.affiliation: Faculty of Health and Social Care, London South Bank University, London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Whittock
authors.affiliation: Faculty of Health and Social Care, London South Bank University, London, UK.
authors.forename: Ferew
authors.initials: F
authors.lastname: Lemma
authors.affiliation: Faculty of Health and Social Care, London South Bank University, London, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Belling
authors.affiliation: Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Clement
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Burns
authors.affiliation: Tavistock Centre, London, UK.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Catty
authors.affiliation: WISERD, School of Social Sciences, Cardiff University, Cardiff, UK.
authors.forename: Ian Rees
authors.initials: IR
authors.lastname: Jones
authors.affiliation: Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
authors.affiliation: Department of Psychology, Psychology and Neuroscience, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Til
authors.initials: T
authors.lastname: Wykes
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D008131:London; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D036301:Qualitative Research
keywords: continuity of care; general adult psychiatry; health professionals; mental health services; service users