Perceptions of information and participation in child and adolescent mental health care: a comparison of patient and caregiver reports across inpatient and day hospital settings

BACKGROUND: In child and adolescent mental health services (CAMHS), the principles of information provision and participatory decision-making have gained prominence, reflecting both legal mandates and ethical standards. Within the last few years, the number of day hospital treatment programs has increased and political decisions led to a reduction in inpatient beds. Given the structural and procedural differences between the treatment settings, this study examines whether patients' and caregivers' ratings of information and participation differ between an inpatient treatment and a day hospital treatment. METHOD: Patients and caregivers answered the "Broad Evaluation of Satisfaction with Treatment" (BEST) questionnaire before discharge from inpatient or day hospital treatment. Two exploratory new subscales were pragmatically composed from existing items in the BEST: An information and a participation subscale. Data from 127 children, 93 caregivers, and 136 adolescents regarding their perception of information provision and participation were analyzed to examine potential differences between the settings. RESULTS: Children and caregivers rated information provision and participation equally high in both treatment settings. Adolescents, however, reported higher satisfaction with information provision during day hospital treatment compared to inpatient treatment. Gender and diagnosis affected the evaluations of participation within the adolescent sample. In the child sample, gender had an effect on the ratings of participation. The subscales Information and Participation show good reliabilities in the adolescent and in the caregiver samples, whereas within the child sample, only the participation subscale shows sufficiently good psychometric properties. CONCLUSION: Despite structural and conceptual differences between the settings, there are no significant differences in the perception of participation. Adolescents in the day hospital, however, reported higher satisfaction with information than adolescents in inpatient treatment. One possible explanation could be a participatory treatment planning tool that is used in the day hospital for adolescents. This tool addresses the item "Goals of treatment discussed" which is located in the information subscale. The subscales of the BEST questionnaire, particularly those related to information and participation, may be helpful in highlighting and fostering person-centered care, especially for adolescents.