Consumer satisfaction with private child and adolescent mental health services in Buenos Aires

The assessment of consumer satisfaction (CS) in child and adolescent mental health services (CAMHSs) is becoming more important due to the increasing emphasis on consumer involvement in mental health services. The majority of the research has been carried out in high income countries (HICs), such as the UK, however, and there is a distinct lack of similar research in low and middle income countries (LMICs), such as Argentina. This is typical of mental health research more generally (the so-called 10/90 Gap, e.g. Saxena, Paraje, Sharan, Karam, & Sadana, 2006). The aims of this study were as follows: 1) Test the viability of carrying out a CS study outside of the HIC context by transferring the methodology of a UK based study (Barber, Tischler & Healy, 2006) to Argentina. 2) Introduce an original Spanish version of the self-report, English Experience of Service Questionnaire (Commission For Health Improvement, 2001). 3) Generate findings about CS in Argentina, of relevance to this context. Specifically, to explore the relationship between young persons' symptoms and their satisfaction with three private CAMHSs in Argentina, and examine the relationship between CS and the age of the children and adolescents, the types of problems with which they presented, and the impact of these problems. Data were elicited from participants using the new Spanish ESQ. In the three CAMHSs which participated, the practice of seeking user feedback was found to be viable, with sufficient data gathered for analysis to provide meaningful results. The Spanish ESQ was also found to be a viable measure, with satisfactory internal reliability and no difficulties for participants in completing the instrument. Specific findings about CS in the Buenos Aires CAMHSs showed that while high levels of CS were reported for all groups, they were significantly higher for parents than for children and adolescents. There were no significant differences found in CS for different age groups. Children and adolescents who reported behavior problems were less satisfied with CAMHSs, as were those who rated their problems as having a significant impact on their lives. Also, those parents who reported their child as having behavioral problems and lack of pro-social behaviors showed lower levels of CS. The results highlight the viability of CS research in LMIC CAMHSs, the viability of the Spanish ESQ, and the need to address those areas of lower satisfaction revealed by the study by exploring further the needs and expectations of young people and their parents who present behavioral problems in order to improve the quality of CAMHSs. Further research should also extend this small sample of the Argentine child mental health services by carrying out similar studies in other private sector services, other geographical regions and also in the public sector, where findings (along with the expectations of users) may differ.