Valuing quality in mental healthcare: A discrete choice experiment eliciting preferences from mental healthcare service users, mental healthcare professionals and the general population

Donna Rowen*, Philip A Powell, Arne Risa Hole, Maria-Jose Aragon, Adriana Castelli, Rowena Jacobs

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


High and sustained healthcare quality is important worldwide, though health policy may prioritise the achievement of certain aspects of quality over others. This study determines the relative importance of different aspects of mental healthcare quality to different stakeholders by eliciting preferences in a UK sample using a discrete choice experiment (DCE). DCE attributes were generated using triangulation between policy documents and mental healthcare service user and mental healthcare professional views, whilst ensuring attributes were measurable using available data. Ten attributes were selected: waiting times; ease of access; person-centred care; co-ordinated approach; continuity; communication, capacity and resources; treated with dignity and respect; recovery focus; inappropriate discharge; quality of life (QoL). The DCE was conducted online (December 2018 to February 2019) with mental healthcare service users (n = 331), mental healthcare professionals (n = 510), and members of the general population (n = 1018). Respondents’ choices were analysed using conditional logistic regression. Relative preferences for each attribute were generated using the marginal rate of substitution (MRS) with QoL as numeraire. Across all stakeholders, being treated with dignity and respect was of high importance. A coordinated approach was important across all stakeholders, whereas communication had higher relative importance for healthcare professionals and service users and ease of access had higher relative importance for the general population. This implies that policy could be affected by the choice of whose preferences (service users, healthcare professionals or general population) to use, since this impacts on the relative value and implied ranking of different aspects of mental healthcare quality.
Original languageEnglish
Article number114885
Number of pages9
JournalSocial Science & Medicine
Early online date21 Mar 2022
Publication statusPublished - 1 May 2022

Bibliographical note

© 2022 The Authors.


  • Choice Behavior
  • Delivery of Health Care
  • Health Personnel
  • Humans
  • Mental Health Services
  • Patient Preference
  • Quality of Health Care
  • Quality of Life

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