Exploring Information Sharing and Confidentiality in Mental Health from the perspectives of Healthcare Professionals, Carers, and Service Users.

Abstract

This study aimed to explore Healthcare Professionals, Carers and Service Users experiences of sharing information in mental health. On reviewing the policy on sharing information, it was found to be ambiguous and focused on the legal aspects of breaking confidentiality and sharing information. Phase 1: Website Audit. Aim - To identify which mental health trusts in England have information on their website about the Triangle of Care and information for carers, explaining sharing information. Method - Appraisal of all the mental health trusts websites. Results - Information sharing material is not consistent in its content or message. Trusts may not consider it a priority to share information via the internet. Subscription to the Triangle of Care was not consistent with a policy on information sharing that was available via the internet. Phase Two: Systematic Review. Aim - To identify and synthesise the evidence, barriers and facilitators from the perspective of the mental health carer, service users and healthcare professionals about information sharing. Method - Systematic review focusing on the barriers and facilitators encountered in communication between the carer, service users and healthcare professionals. Results - 26 studies were included that elicited gaps in knowledge: service users needed to decide on their carer, and for carers, there is a need to be involved as key collaborators. Consent to share information needs to be discussed by healthcare professionals. Phase Three: Focus Groups. Aim - To gain an understanding of the carer and service user perspectives on information sharing. Method - To conduct focus groups with carers and service users to elicit concerns and identify key themes that can formulate questions that may be useful in understanding the issues in information sharing. Results - Consistency in healthcare professionals that supported information sharing. Service users want information shared with carers but require healthcare professionals to facilitate this process. A functioning carer-service user relationship can be significantly and negatively impacted if effective information sharing procedures are not in place. Phase Four: Interviews. Aim - To identify carers issues around information sharing. Method - 17 carers were interviewed to understand the issues for carers about information sharing. Results - There is a change with GPs providing service users care (rather than mental health clinicians), and they could be vital to facilitating sharing information. There is significant conflict in the role for carers as they can also be their mother, sister, brother etc. Carers require a range of information personalised to that service user but not personal information. Conclusions: Information sharing is complicated and has many different stakeholders (service users, carers and healthcare professionals). What is required is a mutual understanding of the rights and responsibilities regarding information sharing of all three parties: service user, carer and health professional. Implications for policy: If confidentiality as a term was better understood at the strategic level it could inform the operational level, giving healthcare professionals clearer guidance as to what information is confidential. Implications for research: BAME focused research that considers if there are similar needs for all carers. Digital technology-focused solutions could be researched to improve information sharing with carers. Implications for practice: Carers want to support healthcare professionals, including training. Different methods of facilitating information with carers need to be considered, such as telephone or written information. Due to service reductions, GPs are delivering a large proportion of mental healthcare and consideration should be given to any training requirements.

Date of Award	6 Jan 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Karina Lovell (Supervisor) & Penny Bee (Supervisor)