Service user experiences of mental health assessments: a systematic review and thematic synthesis of qualitative literature

Background Successive governments have placed service users’ experiences at the heart of mental health services delivery and development. However, little is known about service users’ experiences of assessments and there is some evidence that assessments can cause harm. Aims To synthesise the qualitative literature on service users’ experiences of undergoing mental health service assessments. Methods Literature was systematically searched, screened and extracted, following PRISMA guidelines. Several search strategies were employed, including electronic database searches, handsearching, and forward and backward citation tracking, to identify literature which contained data on service users’ experiences of mental health assessments. Thematic synthesis was used to derive a set of themes underpinning these experiences. Results Of the 10,137 references screened, 47 were identified as relevant to the review. Two main themes were identified: the importance of humanising assessment processes and experiences of service user agency, with each theme containing four sub-themes. Conclusions Findings highlight key factors determining service user experience. We identify key practice implications, contextualised within the literature on trauma-informed approaches and conclude that trauma-informed approaches may aid understanding and improvement of people’s assessment experiences. Further research into the experiences of people from Black and minority ethnic communities is indicated