Quality of life of people with mental health problems: a synthesis of qualitative research

Purpose: To identify the domains of quality of life important to people with mental health problems. Method: A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis. Results: We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization. Conclusions: Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.