In 2017, the UK government announced an independent review of the Mental Health Act 1983 (MHA). We were asked to conduct a six-week qualitative evidence synthesis focusing on the experiences of service users, their relatives, carers and professionals of the nearest relative (NR) provision of the MHA.
To describe the methodological challenges experienced and solutions identified when producing a systematic review of qualitative evidence in six weeks.
We allocated three weeks to plan the review, identify and screen studies and one week to write up the results, leaving two weeks to conduct the qualitative evidence synthesis. Due to this time constraint, we elected to use a framework approach. Our initial framework was constructed around our five research objectives, due to the lack of an available theory-based framework in the literature. This identified three studies which contributed the most data to our research aims and represented a variety of stakeholder views. We used the themes from these papers to revise our initial framework and the findings from the additional nine studies were incorporated into this revised framework. Inductive thematic analysis was conducted in the final stages of our synthesis.
The methodological approach allowed a team of three reviewers to complete an appropriate synthesis of the evidence, which included the identification of themes and subthemes, in response to the research objectives. The limited time period available for this review meant the exploration of nuance within the data was limited, reducing the depth of the analysis.
The novel framework approach enabled the identification of core issues relevant to the stakeholders involved in the NR provision of the MHA. Given more time, an inductive thematic analysis would have allowed for a more complete exploration of the issues contained within the primary studies included in this review.
Patient or healthcare consumer involvement:
Despite (and because of) the time restrictions, we were keen to incorporate patient involvement in this review. A carer of a family member with experience of involuntary hospital admission provided invaluable feedback on the themes during their development.