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Co-producing mood clinic assessment forms: Part four – finalising the forms

In this fourth article, Research Associate Helen Page shares the final stage of reviewing online assessment forms for the forthcoming Mersey Care Mood Clinic. With input from a diverse range of service users, these forms aim to ensure inclusivity and usability.

Please note in this article some service users have asked to be referred to by their initials rather than first names.

The updated forms

After a lot of work, we had updated the online assessment forms for the Mersey Care Mood Clinic to include:

• a new long term depression form
• a simplified single form for past medication, so people only complete one form for all past medications
• a single simplified form for talking therapies
• a new form asking about people’s support networks.

Insights from service user CB

After reviewing the forms again, further suggestions from M-RIC Service User and Carer Representative CB were:

• Add an introduction to the very first form to explain the value of completing all the forms.
• Make it clear that any information given won’t affect people’s benefits and that the clinic isn’t connected to the benefits agency in any way.
• On the new support networks form, there are some statutory questions for safeguarding purposes about having a child under 18 at home. This could deter people from disclosing information about their mental health out of fear of having their children taken away from them.
• Revising the language around being in hospital to: “If you have stayed in hospital for your mental health, was this a voluntary stay or were you detained against your wishes (people sometimes call this being “sectioned” under the mental health act), or both? You can tell us more details about those hospital stays here, if you like”.
• On the new simplified past medication form, people who have lived outside UK may have taken medication which could have different names to the ones listed so an extra question should be added, “If the name of the medication you have taken previously does not appear above, please name it here.”
• A few additions to the simplified talking therapies’ form.

Very useful additional feedback from CB!

Review by M-RIC Service User and Carer Representative Tashi

Tashi is an M-RIC Service User and Carer Representative and has experience of long-term and complex depression. Her useful insights included:

• Confirm if people are happy to have been referred by asking on the form, “Do you know you have been referred to the mood clinic? If you are happy to continue with this referral, please fill in this form”.
• Reiterating previous concerns about asking about education and employment on diversity monitoring forms.
• Having separate questions about biological sex and gender identity, asking if people still identify in the same way as at birth.
• Reflecting on her own experience, ask people about their first episode of depression, as that is usually more prominent in people’s memories. Then more general questions could be asked about how the episodes have affected you and how it has impacted on your daily activities.
• Include self-harming behaviour to the list of symptoms people might have had during an episode of depression.
• If people have had a lot of hospital admissions, they might not be able to say how many. Instead, provide tick box ranges (e.g. 0-2, 3-5, 5-10, 10+) plus additional options (“prefer not to say” and “I can’t remember”).
• It would be useful to ask if your hospital stays were positive or helpful with an additional box to provide more details.
• Streamline medication and therapy forms with fewer questions and large text boxes for key information.
• Make it easier for people to navigate through the forms by adding question numbers and numbering the forms.
• Have instructions at the beginning of the episodic depression forms to make it clear which forms you should fill in: e.g, “Only fill in this form if you have had separate episodes of low/high mood where you have recovered in between and don’t fill in this form if you have had prolonged depression with no recovery.”
• Separate out regular medication from additional medication asking, “Do you have any medication you sometimes take on a short-term basis? What is it?” Then a have a box to fill in. Or we could give that option for each medication ticked.
• Test the forms with younger service users as most people consulted so far are middle-aged.

Tashi’s insights, rooted in her lived experience, were invaluable in refining the forms for accessibility and ease of use.

A further review by Public Advisor Matt

M-RIC Public Advisor Matt has previously reviewed the forms as part of his perspective as a service user with bi-polar disorder. After changes had been made following his first session, we caught up again to focus on some specific areas.

They included reviewing:

• Updated versions of the history of depression (discrete episodes) forms to approve the layout and wording for symptoms of hypomania (a psychiatric condition that involves a period of elevated mood and increased energy or activity level that’s less severe than mania).
• Refined language on inpatient admissions and being sectioned under the Mental Health Act.
• A new neuromodulation therapy form; adding a brief description of neuromodulation and taking out the question about dose and asking instead,
  • Can you describe how many sessions you had and over what time period?
  • When did you last have it?
  • Would you recommend this service to other people? (yes/no/not sure).

Matt’s feedback helped fine-tune the forms to better capture patient experiences while simplifying complex sections.

Conclusion

The forms are almost ready, and it has been a really interesting and useful process to develop the co-assessment forms alongside our expert patients and service users. As the Mersey Care Mood Clinic prepares to launch, I’m grateful to everyone who contributed their time and expertise to make these forms as user friendly as possible.