The Role of Qualitative Methods in Evidence based Health Care Brian Williams, University of Dundee Quality of evidence is not an inherent attribute of a design or methodological approach alone, but is also dependent on the question for which evidence is being sought. Qualitative methods seek to answer different questions from those of RCT, and for those types of questions they potentially provide a high level of evidence, higher than that of the RCT. “Potentially” remains an important qualification since as with any research the level of evidence produced is also dependent on the rigour of the study itself. Just as a poorly designed or conducted RCT provides weak evidence so too with a qualitative project. A)What questions can qualitative methods provide a high level of evidence for? The subject matter of qualitative research is not the physical world itself but rather how it is interpreted and understood by individuals, societies and cultures. Consequently, it is concerned with exploring people’s perceptions of the world, their beliefs, attitudes and experiences, and conceptualising these in ways that are both meaningful and useful. It attempts to achieve understanding rather than explanations as such. Within contemporary health care such perspectives are important for two reasons. Firstly, the move towards more patient-centred care suggests that the meaning which an individual attaches to a clinical problem should be regarded as important and addressed where possible (Stewart et al. 1995; Williams 1995; Williams and Grant 1998). Secondly, the ongoing concern with health and illness behaviour (risk taking, adherence to prescribed regimen, appointment keeping etc) largely depends on a knowledge of people’s attitudes and beliefs as the content of most social cognition models in health psychology demonstrate (Conner and Norman 1998). The contribution that qualitative methods can make to the design and implementation of evidence- based mental health care may become clearer by initially considering how well they can answer three types of questions. Question Level of Evidence Provided by Qualitative Approach  What exists? High  Questions of Process Moderate