This study aims to build a measure for assessing and reviewing the living conditions, care and human rights of people with long term mental illness in psychiatric and social care institutions. Protection of their human rights is imperative since impaired mental capacity secondary to mental illness can make them vulnerable to abuse and exploitation from others. They constitute a major resource pressure for mental health services, social services, informal carers and society as a whole. This study will use an iterative methodology to develop a toolkit to assess internationally agreed domains of care relevant to commissioners, providers and service users. The study will assess the ability of the toolkit to feed into established systems to improve care and it will assess value for money. The toolkit will constitute standardised measures of domains considered most important for recovery. The domains will be identified through Delphi exercises in partner countries with professionals, service users and carers and common domains will be agreed by an international expert panel. These are likely to include: the built environment; treatments and content of care; clinical governance; organisational climate; the use of restraint and other coercive practices; social dislocation; the promotion of social inclusion; the use of recovery based practices. The domains will incorporate cross-cutting themes to assess the institution's promotion of human rights e.g. the freedom, choice, dignity and privacy of their clients. The toolkit will be refined through the course of the study to maximise its usability and its ability to deliver assessments that translate into action plans within each country's established systems of change at local, regional and national level. It will be cross-validated against service users' quality of life, autonomy and markers of recovery to test whether it can deliver a proxy-measure of the promotion of human rights and recovery.
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