Search results

1 – 10 of over 2000
Article
Publication date: 6 March 2023

Kristina Brenisin, Mc Stephen Padilla and Kieran Breen

Transition from inpatient mental health care to community living can be very difficult, as people are at an increased risk of suicide, self-harm and ultimately readmission into…

Abstract

Purpose

Transition from inpatient mental health care to community living can be very difficult, as people are at an increased risk of suicide, self-harm and ultimately readmission into hospital. There is little research conducted exploring peer support workers’ (PSWs) lived experiences that could provide insight into the key transitions of care, particularly the support required after discharge from inpatient mental health care. The purpose of this paper is thus to provide a particular insight into what it feels like being discharged from psychiatric care from a PSW’s perspective, how may support be improved post-discharge and what factors might impact the potential for readmission into inpatient care.

Design/methodology/approach

A qualitative, phenomenological approach was adopted to explore and describe PSWs’ lived experiences of transitioning from psychiatric care. Four PSWs who were employed by a UK secure mental health facility were recruited. PSW is a non-clinical role with their main duty to support patients, and they were considered for this type of the study for their experience in negotiating the discharge process to better carry out their job as a PSW.

Findings

After being discharged from psychiatric care, PSWs experienced issues that had either a negative impact on their mental wellbeing or even resulted in their readmission back into inpatient psychiatric care. This study identified three inter-related recurrent themes – continuity of support, having options and realisation, all concerning difficulties in adjusting to independent community life following discharge. The findings of the study highlighted the importance of ensuring that service users should be actively involved in their discharge planning, and the use of effective post-discharge planning processes should be used as a crucial step to avoid readmission.

Research limitations/implications

A deeper insight into the factors that impact on readmission to secure care is needed. The active involvement of service users in effective pre- and post-discharge planning is crucial to avoid readmission.

Practical implications

Mental health professionals should consider developing more effective discharge interventions in collaboration with service users; inpatient services should consider creating more effective post-discharge information care and support packages. Their lived experience empowers PSWs to play a key role in guiding patients in the discharge process.

Originality/value

This is the first study, to the best of the authors’ knowledge, to explore what it feels like being discharged from inpatient mental health care by interviewing PSWs employed at a forensic mental health hospital by adopting a phenomenological approach. This paper offers a deeper insight into the transition process and explores in detail what support is needed post discharge to avoid potential readmission from PSWs’ perspectives.

Details

The Journal of Forensic Practice, vol. 25 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 1 March 2007

Hefin Gwilym

This paper looks at the evolving nature of mental health services. While there has been a shift from asylums to care in the community in recent decades, what is now needed is…

Abstract

This paper looks at the evolving nature of mental health services. While there has been a shift from asylums to care in the community in recent decades, what is now needed is another shift of acute inpatient psychiatric care, away from psychiatric units to community hospitals and other community settings. It is argued that this would be a further step forward in the evolution of mental health services as it would benefit the service users, their families, carers and staff working in acute psychiatric inpatient units.

Details

Journal of Public Mental Health, vol. 6 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 1 January 2005

Norbert Konrad

A high and possibly increasing prevalence of mental disorders in prisoners has been demonstrated in recent surveys. Psychiatric care of prisoners is subject to wide regional…

Abstract

A high and possibly increasing prevalence of mental disorders in prisoners has been demonstrated in recent surveys. Psychiatric care of prisoners is subject to wide regional variations in Germany, especially regarding inpatient treatment. Although hospitalized psychiatric patients in prison closely resemble those in forensic psychiatric secure hospitals with regard to socio‐demographic (percentage of women, age peak) and forensic characteristics (delinquency, prison experience), marked discrepancies in the diagnostic spectrum necessitate very different treatment planning based on general clinical psychiatry when considering the approach and especially the treatment duration. In Berlin, we try to develop a care structure within the prison system, which addresses inmate‐specific problems and circumstances as well as the possibility of inpatient and outpatient treatment and semihospitalization according to the principle of “equivalence”.

Details

International Journal of Prisoner Health, vol. 1 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

Open Access
Article
Publication date: 3 March 2023

Sami Abdulrahman Alhamidi and Seham Mansour Alyousef

The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.

Abstract

Purpose

The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.

Design/methodology/approach

A focus group of 10 graduate psychiatric nurses with more than two years’ practice in inpatient psychiatric settings reflected on their last six months’ work placements and continuous employment. The transcripts and field notes were analyzed through thematic analysis of inductive data.

Findings

Two main themes emerged: management roles and clinical roles. The participants reflected on caring activities and obstacles encountered in fulfilling their professional roles.

Originality/value

Multiple practice issues emerged. The participants perceived that psychiatric nurse specialists are required to perform more caring functions than practicable in the inpatient setting due to an excess of noncaring duties, structural minimization of the caring role and inadequate training. They felt that many of the functions performed were not within their expectations of the caring role of a psychiatric nurse specialist and believed that changes in nurse education and attention to clarification of nurses’ roles might enhance the role they play in patient care.

Details

Arab Gulf Journal of Scientific Research, vol. 42 no. 1
Type: Research Article
ISSN: 1985-9899

Keywords

Article
Publication date: 23 September 2013

Karleen Gwinner and Louise Ward

This paper adds to growing research of psychiatric intensive care units (PICU) by recounting descriptions of psychiatric intensive care settings and discusses the perceptions held…

Abstract

Purpose

This paper adds to growing research of psychiatric intensive care units (PICU) by recounting descriptions of psychiatric intensive care settings and discusses the perceptions held by nurses of the organisational interfaces, arrangements and provisions of care in these settings.

Design/methodology/approach

Data gathered from focus groups held with nurses from two PICUs was used to establish terminology, defining attributes, related concepts, antecedents, values, processes and concepts related to current practices. A literature search was conducted to permit a review of the conceptual arrangements and contemporary understanding of intensive care for people experiencing acute psychiatric illness based on the perspectives held by the nurses from the focus groups.

Findings

Dissonance between service needs and the needs and management of individual patients overshadow strategies to implement comprehensive recovery-oriented approaches. Three factors are reported in this paper that influence standards and procedural practice in PICU; organisational structures; physical structures; and subtype nomenclature.

Practical implications

Acute inpatient care is an important part of a comprehensive approach to mental health services. Commonly intensive acute care is delivered in specialised wards or units co-located with acute mental health inpatient units mostly known as PICU. Evidence of the most effective treatment and approaches in intensive care settings that support comprehensive recovery for improved outcomes is nascent.

Originality/value

Current descriptions from nurses substantiate wide variations in the provisions, design and classifications of psychiatric intensive care. Idiosyncratic and localised conceptions of psychiatric intensive care are not adequately entailing effective treatment and methods in support of recovery principles for improved and comprehensive outcomes. The authors suggest that more concrete descriptions, guidelines, training and policies for provision of intensive psychiatric health care encompassing the perspective of nursing professionals, would reinforce conceptual construction and thus optimum treatments within a comprehensive, recovery-oriented approach to mental health services.

Details

Mental Health Review Journal, vol. 18 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

Book part
Publication date: 28 December 2006

Kathleen Biebel and Jeffrey L. Geller

A system of care is a function-specific, rather than agency-specific approach defined as a “comprehensive spectrum of mental health and other necessary services which are…

Abstract

A system of care is a function-specific, rather than agency-specific approach defined as a “comprehensive spectrum of mental health and other necessary services which are organized into a coordinated network to meet the multiple and changing needs of children and adolescents with severe emotional disturbances and their families” (Stroul & Friedman, 1986). A system of care provides a mental health delivery system for children with SED with a wide array of accessible, community-based services that focus on children's individual needs, include the family in treatment planning, and provide culturally competent services. System of care services are provided by multiple child serving agencies and are collaborative and coordinated (Stroul & Friedman, 1986).

Details

Research on Community-Based Mental Health Services for Children and Adolescents
Type: Book
ISBN: 978-1-84950-416-4

Article
Publication date: 1 September 2007

Ian Baguley, Jane Alexander, Hugh Middleton and Roslyn Hope

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is…

Abstract

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users1 a quality of care that meets their needs and expectations.

Details

The Journal of Mental Health Training, Education and Practice, vol. 2 no. 2
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 3 March 2014

Sue Mesa and Elias Tsakanikos

The purpose of this paper is to investigate whether acute inpatient psychiatric staffs’ attitudes and self-efficacy towards adults with mild intellectual disability, were…

Abstract

Purpose

The purpose of this paper is to investigate whether acute inpatient psychiatric staffs’ attitudes and self-efficacy towards adults with mild intellectual disability, were different than towards the general mental health population. And whether their understanding of the policy for those with mental illness and intellectual disability differed.

Design/methodology/approach

The study is a between-subject design, using a self-administered postal questionnaire. The sample was all qualified staff from the acute inpatient psychiatric provision of an inner London borough. Potential participants were randomly assigned to two research groups, half being given a questionnaire regarding people with intellectual disability and the other half an identical one regarding people with mental illness. Comparisons were made between the two.

Findings

The majority of staff were unaware of the current policy direction for adults with intellectual disability although were on the whole in agreement to the idea that they should access mainstream services. Staff overall did not have more negative attitudes to those with intellectual disability although were less likely to empower or encourage self-advocacy. Staff were significantly less confident that they had sufficient training and experience, and in their perceived ability to be able to communicate, assess and treat adults with mild intellectual disability when compared to those with mental illness.

Research limitations/implications

The response rate and small sample size is a limitation. Further research could usefully look at whether self-efficacy and attitudes differ in different models of mainstream psychiatric care.

Originality/value

Government policy in the UK regarding services for people with intellectual disability advocates for inclusion and equality (Chaplin and Taggart, 2012). Those requiring psychiatric care should access this from mainstream services (Department of Health, 2001, 2009, 2011; Foundation for People with Learning Disabilities et al., 2004; Bradley, 2009.) There are, however, no UK-based studies investigating the views of mainstream acute inpatient psychiatric staff towards their role. Intellectual disability staff have concerns about their attitudes and self-efficacy and it is know that acute care is the setting where most adults with intellectual disability will come across mainstream psychiatric staff. Findings have relevance to managers and staff in both intellectual disability and psychiatric services and could be considered in the context of trying to work together as is the direction of policy.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

Open Access
Article
Publication date: 4 September 2017

Chris Lloyd, Philip Lee Williams, Gabrielle Vilic and Samson Tse

Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been…

4382

Abstract

Purpose

Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been made with introducing recovery-oriented practice in many areas of mental health practice, but there remain areas where progress is delayed, notably, the psychiatric inpatient environment. The peer support workforce can play a pivotal role in progressing recovery-oriented practices. The purpose of this paper is to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

Design/methodology/approach

The authors reviewed current literature and considered practical approaches to building a peer workforce in collaboration with occupational therapists.

Findings

It is suggested that the peer support workforce should be consciously enhanced in the inpatient setting to support culture change as a matter of priority. Occupational therapists working on inpatient units should play a key role in promoting and supporting the growth in the peer support workforce. Doing so will enrich the Occupational Therapy profession as well as improving service user outcomes.

Originality/value

This paper seeks to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

Details

Irish Journal of Occupational Therapy, vol. 45 no. 2
Type: Research Article
ISSN: 2398-8819

Keywords

Article
Publication date: 9 March 2015

Christopher Alan Griffiths, Samira Heinkel and Bohdana Dock

The purpose of this paper is to evaluate the impact on recovery and personal goal attainment of a transition intervention service for return to the community following exit from…

Abstract

Purpose

The purpose of this paper is to evaluate the impact on recovery and personal goal attainment of a transition intervention service for return to the community following exit from an alternative to psychiatric inpatient admission – a residential recovery house. The services seek to facilitate community reintegration, promote recovery and prevent future mental health crisis. The service was funded by the Stone Family Foundation.

Design/methodology/approach

This evaluation employed a within groups design: a single case evaluation follow-up. Analysis of Recovery Star and personal goal achievement data collected at service entry and exit points during routine practice (n=181), at four sites in England. The adults had mental illness diagnoses including depression, schizophrenia, bipolar disorder, personality disorder, and anxiety disorder.

Findings

There was a significant increase in overall Recovery Star scores with a large effect size, and significant increases in eight of the ten Recovery Star life domains. There were significant increases in the goal scores linked to “Managing mental health”, “Self-care” and “Living skills”.

Practical implications

A transitional intervention service provided by the third sector for return to community following mental health crisis may contribute to recovery and personal goal achievement. A randomised control trial of this transition intervention service is recommended.

Originality/value

This is first outcome evaluation of an alternative to psychiatric inpatient admission transition intervention service and findings indicate the potential positive effect of having this service incorporated into the design of alternative to admission provision.

Details

The Journal of Mental Health Training, Education and Practice, vol. 10 no. 1
Type: Research Article
ISSN: 1755-6228

Keywords

1 – 10 of over 2000