Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

Schmidt, Manuela; Stjernswärd, Sigrid; Garmy, Pernilla; Janlöv, Ann-Christin

doi:10.3390/ijerph17031012

Cited by 7 publications

(8 citation statements)

References 41 publications

(61 reference statements)

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“…A recent qualitative study conducted in Sweden explored the experience of encounters with frequent users of psychiatric ED among nurses and physicians. 17 The main findings revealed that psychiatric ED nurses and physicians found their encounters with frequent users as "caring, professional, and human processes" requiring specific abilities, such as self-awareness, self-acceptance, and self-compassion. Another qualitative study conducted with the same sample explored ED staff understanding of frequent users and their needs.…”

mentioning

confidence: 99%

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Bodenmann

Kasztura

Graells

et al. 2021

INQUIRY

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Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers’ challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Participants were asked to indicate the extent to which they perceived that FUED represented a problem and to describe the main challenges encountered. In total, 208 physicians and nurses from 75 EDs (70.7%) completed the survey. Among the 208 participants, 134 (64%) reported that FUED represented a challenge and 133 described 1 to 5 challenges encountered. A conventional content analysis yielded 4 main categories of perceived challenges. Negative consequences in the ED secondary to FUED’s presence (eg, ED overcrowding, staff helplessness, and fatigue) was the most frequently reported challenge, followed by challenges related to FUEDs’ characteristics (eg, mental health and social problems) leading to healthcare complexity. The third most frequently encountered challenge was related to the ED inappropriateness and inefficiency to address FUEDs’ needs. Finally, challenges related to the lack of FUED healthcare network were the least often mentioned. ED healthcare providers experience a wide range of challenges related to FUED care. These findings suggest that currently EDs nor their staff are equipped to address FUEDs’ complex needs.

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confidence: 99%

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Bodenmann

Kasztura

Graells

et al. 2021

INQUIRY

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“…When initial contextual barriers were overcome the RG intervention had the potential to provide staff with new perspectives on mental health and recovery, organizational capacity to integrate a recovery approach and users with a meaningful outlet of lived experience to influence treatment goals. The actual delivery provided staff with experiences and tools to ‘do things with users’, to start a conversation, listen, learn, share and plan for care and recovery goals and, to reach common grounds, which previous research has emphasized 2,12,15 …”

Section: Discussionmentioning

confidence: 99%

“…The actual delivery provided staff with experiences and tools to ‘do things with users’, to start a conversation, listen, learn, share and plan for care and recovery goals and, to reach common grounds, which previous research has emphasized. 2 , 12 , 15 …”

Section: Discussionmentioning

confidence: 99%

“…In Sweden, inpatient staff perceived that they had limited time for reflection and sharing experiences with colleagues, and thus expressed a desperate need for resources and strategies to meaningfully connect with users. 15 Likewise, staff in Australia emphasized the need for a clear description and support on how to become recovery‐oriented. 12 A review of recent literature clearly emphasizes that users and staff need tools to enhance common ground and that recovery values and interventions are needed in inpatient MHS.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of the Recovery Guide in inpatient mental health services in Sweden—A process evaluation study

Bejerholm

Allaskog²,

Andersson³

et al. 2022

Health Expectations

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Background: Involving service users in inpatient care and recovery planning has gained interest worldwide. Our purpose was to evaluate the process of implementation of a coproduced Recovery Guide (RG) intervention in 22 inpatient wards in Sweden, in terms of context, implementation process and mechanisms of impact over 12 months.Methods: A mixed method design and a process evaluation framework were used to guide data collection and to deductively analyze perspectives and descriptive statistics of delivery from three stakeholder groups.Results: Results showed that although initial contextual barriers were present (e.g., lack of resources, and interest, uncertainty in the organization, a dominant illness perspective), it was possible to implement the RG in 14 wards, where 53% of admitted service users received the intervention. Legitimacy of the intervention, engaged managers and staff, capacity of staff and ward organization, coproduction and continuous support from user organization were critical mediators.Mechanisms of impact concerned (1) a new perspective on mental health, wellbeing and recovery, (2) capacity building of a recovery approach in inpatient settings and (3) a meaningful outlet for users' thoughts and feelings on recovery, sharing narratives and influencing care and goals. Conclusions:The RG intervention has the potential to promote a recovery approach in inpatient mental health services (MHSs). Coproduction among stakeholders created trust and a sustainable implementation that made it possible for wards to resume implementation when contextual barriers had been resolved. Patient and Public Contribution:The current study involved stakeholders including a service user organization, the public, first-line managers and staff (including peer support workers) in inpatient and community MHS and researchers, who greatly contributed to the implementation programme, including codesign of the RG intervention as well as coproduction of the implementation in inpatient MHS. All

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“…These include psychiatric crisis and emergency departments, the creation of mobile psychiatric teams, crisis hotlines, and psychiatric reception centers. The use of psychiatric emergency departments has particularly increased over the last decades ( Schimdt et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“We Become a Madman to Be Calmed”—Patients’ Voices: Crossing the Threshold of Psychiatric Emergency Departments

Meriaux

Denis

2021

Front. Psychol.

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Crossing the threshold of a psychiatric emergency room is a real ordeal. It is a passage that upsets, worries and sometimes paralyzes. However, it can also become an opportunity if psychological suffering is welcomed, accepted and understood. The welcome is the starting point for care. Our objective is to understand the meaning given to the phenomenon of “being welcomed” by patients experiencing psychiatric emergencies. The research is based on Grounded Theory Methodology (Glaser and Strauss, 1967) to explore and understand the complexity of the phenomenon. The results reveal that being welcomed can be considered as a rite of passage taking place in four successive phases, which are themselves organized into four interactive dimensions. The welcome as a rite of passage constitutes a powerful psychic support which arranges the transitional space in which the individual finds themself, and accompanies the identity transformations, the anguish, and the various sufferings which are not lacking in these moments of crisis.

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Encounters with Persons Who Frequently Use Psychiatric Emergency Services: Healthcare Professionals’ Views

Cited by 7 publications

References 41 publications

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Implementation of the Recovery Guide in inpatient mental health services in Sweden—A process evaluation study

“We Become a Madman to Be Calmed”—Patients’ Voices: Crossing the Threshold of Psychiatric Emergency Departments

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