Quality and Satisfaction in Youth Mental Health Care: A Nigerian Perspective

Abstract

The global shift toward community-based mental healthcare highlights the importance of service-user involvement in the co-design of effective and acceptable care. This mixed-methods study assessed service-user satisfaction and explored barriers and facilitators to care at the Child and Adolescent Mental Health outpatient clinic of the University College Hospital, Ibadan, using a triangulation design. Quantitative data were collected from 44 adolescents and 21 caregivers using the Patients’ Perception of the Quality of Services Questionnaire and the Satisfaction with Life Scale, while qualitative in-depth interviews were conducted with a subset of 12 adolescents and 8 caregivers to explore perceptions of care quality, access, and improvement needs. Overall satisfaction with care was high, with caregivers reporting slightly higher satisfaction than adolescents. High satisfaction was reported by 72.7% of adolescents and 76.2% of caregivers, and no participant reported low satisfaction. Mean satisfaction scores were 86.25 (SD = 13.00) for adolescents and 86.67 (SD = 11.84) for caregivers. Sociodemographic characteristics and clinical diagnosis were not associated with satisfaction with care; however, satisfaction with services was significantly associated with participants’ subjective wellbeing. Qualitative analysis identified barriers, facilitators, and recommendations for service improvement. Key barriers included long waiting times, cumbersome administrative processes, unpredictable services, persistent symptoms and medication side effects, financial costs, and distance to the facility. Facilitators to continued care were perceived improvement in patients’ health and positive staff attitudes. Participants recommended reducing waiting times, streamlining clinic processes, lowering costs, improving staff attitudes and communication, and increasing consultation time with clinicians. In conclusion, findings suggest that both adolescents and caregivers were satisfied with the quality of care provided. However, the study underscores the importance of actively involving adolescents in treatment planning and service development to enhance engagement, adherence, and continuity of care, and to reduce the risk of dropout in child and adolescent mental health services.