Comparison of a co-produced mental health service to traditional services: A co-produced mixed-methods cross-sectional study.
Raffaella Pocobello, Tarek El Sehity, Luca Negrogno and 3 others
PMID 31820569WHAT IT FOUND
Users of a co-produced mental health centre reported 63% fewer hospitalizations and more reductions in psychiatric medication than users of traditional day centres.
Qualitative participants described the co-produced service as offering respect, freedom, and continuity of care.
Key findings
01After adjusting for confounders, users of the co-produced centre had 63.2% fewer hospitalizations than those in traditional services.
0239% of users in the co-produced centre reported a reduction or withdrawal from psychiatric medications, compared to 22% in the comparison group.
03Qualitative themes identified differences including parity and respect versus asymmetric relationships, and focus on strengths versus focus on illness.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study design was cross-sectional and observational, so it cannot prove that the co-produced service caused the reductions in hospitalization or medication use. All outcome data were self-reported by users; medical records were not used to verify hospitalization counts or medication changes. The two groups differed significantly in baseline characteristics such as gender, education, and income, which were adjusted for statistically but may still confound the results. The sample was small and limited to one region in Italy, restricting generalizability. The qualitative focus group consisted of participants who already knew each other and were invested in the centre, which may have suppressed critical views of the service.
Declared interests
The study was conducted by researchers from the Italian National Research Council at the request of the association running the centre. No specific funding sources or commercial conflicts of interest are detailed in the provided text.
The easy way to misread this
Do not interpret the 63% reduction in hospitalizations as a proven causal effect of co-production. This was a cross-sectional study using self-reported data from two groups that differed significantly in demographics, and the authors explicitly state the design cannot identify causal relations.