Johnson-Kwochka_First Person Perspectives.pdf

Objective: Because of changes in health care, there is a

greater focus on brief medication management visits as the

primary method of providing psychiatric care in community

mental health settings. Research on the first-person perspectives

of service users and prescribers in these settings is

limited. The objective of this study was to describe firstperson

perspectives on medication management visits and

the service user–prescriber relationship.

Methods: Researchers conducted qualitative interviews as

part of a larger comparative effectiveness trial at 15 community

mental health centers, researchers interviewed service users

(N=44) and prescribers (N=25) about their perspectives on the

typical elements of a medication management visit and asked

service users about their relationship with their prescriber.

Results: Both service users and prescribers described

medication management visits as very brief encounters

focused on medication and symptoms. Most service users

reflected on the service user–prescriber relationship in positive

or neutral terms; they did not describe the development

of a strong therapeutic relationship or a meaningful clinical

encounter with prescribing clinicians.

Conclusions: Service users described the service user–

prescriber relationship and medication management visit

as largely transactional. Despite the transactional nature of

these encounters, most service users described relationships

with prescribing clinicians in positive or neutral terms.

Their satisfaction with the visit did not necessarily mean

that they were receiving high-quality care. Satisfactionmay

instead suggest service users’ disengagement from care.

They may need more support to fully participate in their

own care.