Experiences of acute care by persons with mental health problems: An integrative literature review

Abstract

Accessible summary What is known on the subject? Understanding experiences of acute care by persons with mental health problems is vital for improving these experiences through the development of different parts of the care delivery and its facilities. Literature has extensively addressed experiences of persons with mental health problems in acute care settings. Yet, there is a paucity of studies that aggregate and organize these findings in presenting development‐oriented solutions for the improvements of these experiences. What the paper adds to existing knowledge? Acute care can be understood through patients’ experiences of structure (such as setting, staff and resources); process (such as communication and interpersonal relations); and outcome (such as satisfaction and post‐discharge well‐being and health) and suggests improvements in these domains. The paper illuminates that previous literature has mainly captured negative experiences of acute care by persons with mental health problems, and suggests diverting the focus to the best practices and to seek inspiration from other fields of research. What are the implications for practice? Attending to the improvement and development of different parts of the acute care might be an important step in improving experiences of persons with mental health problems. For example, improving resource allocation systems and facilities, emphasizing professionalism in encounters with these patients and systematically assessing patient satisfaction during and after visits are important areas that require attention. Abstract AimThe provision of acute care to persons with mental health problems is challenging due to difficulties in encountering this group and the vulnerability of these persons. Understanding this group's experiences with acute care is thus an important endeavour. The purpose of this review was to critically and systematically identify and assess previous research on experiences of acute care by persons with mental health problems, guided by Donabedian's structure–process–outcome framework (Prospero ID: CRD42019116652). Method and resultsAn integrative literature review was performed, resulting in the identification of 43 studies. The search was conducted using five electronic databases: Web of Science Core, PubMed, MEDLINE, CINAHL and PsycINFO. DiscussionThe review revealed that patients experienced structure components such as setting, staff and resources in a predominantly negative way. A predominately negative picture also emerged of the process components, where, for example, communication and interpersonal relations were represented by negative experiences, with limited positive experiences reported. The outcome components, related to patients’ satisfaction and their well‐being after discharge, were also predominantly experienced negatively. Implications for practiceUsing Donabedian's framework of structure, process and outcome allowed us to systematize the literature reviewed, to identify the research gaps and to suggest ways forward for the ...

Experiences of people seen in an acute hospital setting by a liaison mental health service: responses from an online survey

“…As previously described in a recent systematic review, structural components of acute care can be experienced as cold or overstimulating [2], and these experiences were echoed by our respondents. In 2011 the Department of Health in England produced a framework of elements critical to patient's NHS experience.…”

“…The percentage for LMHS staff seen do not add up to 100 because some participants selected multiple staff (e.g., nurse and psychiatrist). 2 The percentage of contact with sites do not add up to 100 % as some participants selected 'yes' to multiple sites "Helped me see it was an illness and not that I wasn't strong enough".…”

“…A recent review of experiences of acute hospital care by people with mental health problems identified sixteen previous studies which focused on the emergency department setting [ 2 ]. The review divided experience according to structure (setting and staff), process and outcome (satisfaction).…”

“…Another review of service users' experiences in the emergency department identified nine studies [7]. Services users described stressful experiences with long waiting times [2]. Their experiences of liaison staff were mixed: some described staff as judgmental while others described staff as caring and placing people at ease [8].…”

Nurses’ experiences of encountering patients with mental illness in prehospital emergency care – a qualitative interview study

“…Taking time to listen to the patient, which includes empathy, silence, attention to both verbal and nonverbal communication, and the ability to be non-judgmental and accepting, has always been considered a crucial component of nursing care [ 26 ]. A review study of the experiences of patients with mental health problems shows that they had predominately negative experiences due to poor communication and interpersonal relations [ 27 ]. How nurses come across in the acute care setting is essential for those in crisis as their experience impacts on their satisfaction with care [ 28 ].…”