What are “good outcomes” in public mental health settings? A qualitative exploration of clients’ and therapists’ experiences

BACKGROUND: The mental health field sees a surge of interest in Routine Outcome Monitoring, mandated by a wish to help better those not-on-track to recovery. What constitutes positive outcomes for these patients is not fully understood. AIMS: To contribute knowledge into what constitutes meaningful outcome concepts in the experiences of patients with long and complex mental health suffering and treatment, and the clinicians who work to help them. METHODS: A qualitative in-depth study of 50 participants’ experiences. Data are collected through focus groups and individual interviews, and analyzed using a team based structured thematic analytic approach. RESULTS: We found an overarching theme of outcome as an ongoing process of recovery, with the four constituent themes: (1) strengthening approach patterns for new coping; (2) embodying change reflected by others; (3) using new understandings developed in dialogue; and (4) integrating collaborative acceptance. CONCLUSIONS: We discuss our findings in light of existing empirical studies and different recovery concepts, and suggest that if outcomes monitoring is to become an integral part of routine practice, it might be beneficial to integrate an understanding of outcomes as ongoing processes of recovery within mental health suffering into these systems.