Chapter 8 194 lack of expertise when discussing family planning. Possibly, patients and close ones (those with close relationships with the patients) experience obstacles too. We argue that the perspective and needs of patients, close ones and MHPs should be included when studying family planning issues. This aligns with the contemporary mental healthcare perspective with emphasis on shared decision-making21. In this study, we investigated the need and experiences of patients, close ones and MHPs regarding discussing family planning in mental healthcare during the reproductive phase of life. We also inquired what, when and how MHPs should discuss family planning with patients. Knowledge about the content of a conversation about family planning and desire for children and the role of MHPs could nurture the necessity to implement family planning counseling in mental healthcare practices. Materials and methods Research design We applied a mixed methods design, which enabled integration of qualitative and quantitative data22. This aligns with the post-positivistic approach that equally respects the value of subjective and objective data. The post-positivistic scientific paradigm originates from a realist ontology in which knowledge is a single, objective reality23. However, in this study, we acknowledge that scientific observations (lived experiences with family planning in mental healthcare) are not neutral, but subject to human interpretation. According to the post-positivistic paradigm, we aim to establish possible, not definite truths24. To gain a comprehensive understanding of healthcare needs regarding family planning of persons with mental health issues, close ones and MHPs, we collected experiences through a survey that was conducted prior to the current study25 and through focus groups (as part of the current study). Subsequently, we identified a knowledge gap based on these experiences and explored it in new surveys in two different nationwide samples: one of MHPs and one of (former) patients and close ones. In a sequential analytical design, the qualitative findings from the focus groups and open questions in the surveys complemented the quantitative survey findings. Figure 8.1 displays the study design and data intersection.
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