There is little public or professional knowledge regarding the scale of negative events thatare encountered when seeking mental health care, known as ‘iatrogenic harm’. Although there are professional guidelines, policies and standards in place, prior research and documented events suggest that these are not always adhered to in practice. With up to 65% of practitioners delivering ineffective or harmful outcomes. Those seeking to remedy this are often dismissed and current tools for identifying adverse events or measuring clinical outcomes are not accessible to those accessing services (‘service-users’), nor do they adequately empower them or capture their lived-experiences.
Preliminary demonstration for the validity of the Adverse Behaviours in Clinicians (ABC-11); The first standardised method of identifying and measuring adverse practitioner behaviours inorder to moderate iatrogenic harm and improve outcomes in mental health services.
An eleven question checklist was adapted from a domestic violence resource currently supplied to service-users who have experienced abuse. The resulting questionnaire was made available online and on paper to explore if it was a reliable method of documenting and measuring encounters of harmful behaviours enacted by mental health practitioners.
94% of the 251 participants selected ‘Yes’ to at least one of the checklist items. Overall the average number of checked items (the ABC Score) was 6. There were some notable differences across location and service type but the ABC Scores remained above 6.
The ABC-11 has been demonstrated as a valuable and necessary tool for identifying practitioner behaviours that could result in iatrogenic harm toward service-users. It also validates and empowers them to advocate for the appropriate standards of care required for establishing and maintaining their wellbeing when seeking healthcare. Future research is recommended to further explore the practical uses of the ABC-11, including its application to specific demographics, diagnoses, treatments and settings. It is a public health priority forthose with professional, political and regulatory responsibility to address adverse behaviours in clinicians and provide services that meet the needs and rights of service-users.