Community meetings on acute psychiatric wards: a therapeutic intervention or a meaningless exercise?

Abstract

Although long a feature of inpatient mental health ward routine, community meetings have not always attracted a clear sense of purpose and value. A common complaint from patients is that community meetings are useless and have no worthwhile purpose. It was thought that staff on acute wards would benefit from having a space to think about community meetings, and a work discussion group was provided over a duration of 18 months. It was hoped that this intervention would enable facilitators to think about these meetings and about their aims and benefits. This paper presents findings from the work discussion group: staff facilitators' experience of facilitating community meetings and patients' direct feedback to facilitators about their experience of these meetings. The conclusions made are that community meetings could provide a useful forum for patients and staff if they: • are of benefit to patients • provide a forum for development of the therapeutic alliance between patients and staff • contribute towards improvement of the ward milieu • provide a forum for staff to develop therapeutic skills • provide a forum for staff to develop working relationships with colleagues and different professionals in the team.

What is the Purpose of Community Meeting in an Inpatients Psychiatric Unit ?

“…Searching the literature for evidence of the community meeting purposes as discussed in the literature review section, reveals that all the studies and papers agreed that community meetings will be of benefit to the patients as wel as the staff (Winer, Klamen, 1997;Novakovic, Francis, Clark, & Caring, 2010;Fiddler et al, 2010;Benson, Harms, 2003;Lanza, Rierdan, Forester, Zeiss, 2009).…”

“…According to the psychiatric inpatients units, the community meeting appears to give psychodynamic understanding to the clients about pharmacologic intervention to increase clients compliance to medication (Winer, Klamen, 1997). Novakovic, Francis, Clark, & Caring (2010) stated that community meeting can benefit patients by 1) a space and time to address and solve problems, 2) a safe space to be seen and heard by peers, 3) a space to address issues about relationships between staff and patients, 4) provide connection and intimacy as a group. Community meeting can improve the patient's satisfaction (Fiddler et al, 2010), by discovering new ways of adjusting stressors and promoting self esteem (Benson, Harms, 2003).…”

“…It reveals the attitudes that clients have towards the staff and what is the meaning of these attitudes. It takes feedback from the clients about staff behaviors (Novakovic, Francis, Clark, & Caring, 2010). It also increases the relationships with colleagues and other professionals and provides better access for multidisciplinary team to discuss the patient decisions.…”

“…Community meeting is a part of milieu program (Kisch, Kroll, Gross;& Carey, 1981); it is a regular meeting in an inpatient unit for all staff and patients on the unit. The duration ranges from 45 to 60 minutes, and it can be held once daily to once weekly (Novakovic, Francis, Clark, & Caring, 2010). The members of the meeting includes nurses, social workers, occupational therapists and psychiatrists (Fiddler et al, 2010).…”

“…The purpose of the psychiatric inpatient unit community meeting is often unclear to the staff and patients (Kisch, Kroll, Gross;& Carey, 1981). The frequent complaint from clients is that the community meetings are useless (Novakovic, Francis, Clark, & Caring, 2010).…”