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J Eval Clin Pract. 2011 Dec;17(6):1102-7. doi: 10.1111/j.1365-2753.2010.01474.x. Epub 2010 Jun 25.

Development of a consumer constructed scale to evaluate mental health service provision.

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Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia.



Most mental health outcome and satisfaction measures have been developed by academic researchers or service providers. Consumers have been limited to the role of participant or advisor. The validity and reliability of these satisfaction measures have been challenged. This paper reports the development of a consumer satisfaction questionnaire in which consumers work as collaborative researchers to increase its face validity and relevance.


Eleven themes from a previous participatory study were used by consumer researchers and university-based researchers to generate questionnaire items, with four items reflecting each theme. The internal consistency and factor structure were examined in public and non-government mental health service centres based on data of 202 mental health consumers.


Principal Components Analysis with oblique rotation yielded a two-factor structure: Empowerment and Dehumanization. The two factors together explained 36.7% of the total variance. The scale demonstrated high internal consistency, with Cronbach's alpha for the total scale at 0.92, and for the two factors at 0.92 and 0.80.


The questionnaire was developed in accordance with an evaluation framework of consumer directed evaluation of mental health services. The final questionnaire consists of 26 items. It has satisfactory internal consistency and appeared to be useful with inpatients and outpatients. Further research will be performed to establish its test-retest reliability and criterion validity.

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