Exploring the initial experience of hospitalisation to an acute psychiatric ward

Abstract

BackgroundPatient-reported satisfaction with inpatient psychiatric services, within the first few days of admission, is related to positive future outcomes. Despite its predictive value, little is known about this initial experience and what underlies these appraisals. The aim of this study was to qualitatively explore the initial experience of being admitted to an inpatient psychiatric ward.MethodsSemi-structured interviews were conducted with 61 recently admitted patients across five psychiatric hospitals in London, England. Participants were purposively sampled to ensure a mix of experiences including people with high and low satisfaction scores as measured by the Client Assessment of Treatment. Thematic analysis was used to identify, analyse and report patterns within the data, with content analysis applied to determine whether certain themes were more common to either negative or positive appraisals.ResultsFour broad themes were evident 1) ‘Best place for me right now?’ 2) ‘Different from out in society’ 3) ‘Moving from uncertainty to being informed’ and 4) ‘Relating & Alienating’. Individuals with very positive appraisals spoke most frequently of helpful relationships with both staff and other patients, and feeling cared for. They also spoke of having had previous admissions and the assessment process on entering the ward suggesting that these may be valuable experiences. Conversely, the group with very negative appraisals spoke of relationships that were alienating or where there was a perceived abuse of power. They described restrictions to their freedom, compared hospital to prison and generally had the view that hospital makes you worse.ConclusionsThe experience of hospital within the first few days of admission determines whether an individual has a positive or negative experience of their inpatient care. Reducing the impact of uncertainty and promoting good relationships may help services to improve the initial experience of hospital admission and ultimately improve future outcomes for patients.

Activities on acute mental health inpatient wards: A narrative synthesis of the service users’ perspective

“…While definitions remain unclear as to what makes activities meaningful, the impact of limiting access to such activities has been demonstrated, with evidence denoting a link between the insufficient access to a range of activities and the reported high levels of boredom that are experienced by service users on acute mental health wards (Folke et al, 2018;Lindgren, Aminoff, & Graneheim, 2015;Newell, Harries, & Ayers, 2012;Wood & Alsawy, 2016). High levels of boredom have been found to negatively affect the service user experience (Chevalier, Ntala, Fung, Priebe, & Bird, 2018) and to negatively impact on the ward environment (Akther et al, 2019). This links to the emerging evidence suggesting that engagement in activity is beneficial to patient outcomes.…”

The benefits of consumer involvement in nursing handover on acute inpatient unit: Post‐implementation views

“…In a previous study by Chevalier et al (), it was reported that the sense of not knowing what was happening on the ward and a lack of communication contributed to the overall negative experience of consumers who were receiving care for a mental illness. Participants in that study also reported a perceived divide between themselves and nursing staff.…”

“…Admission to an acute inpatient mental health unit has been reported to be a difficult time for consumers. In a study by Chevalier et al (), participants identified that not knowing what to expect, confusion and chaos on the ward and a lack of communication between staff and consumers contributed to their negative admission experience.…”

Knowing Well, Being Well: well-being born of understanding: Addressing Mental Health and Substance Use Disorders Amid and Beyond the COVID-19 Pandemic

“…This sometimes ends with compulsory psychiatric hospitalization, which has been associated with adverse patient outcomes. 143 , 144 Possibilities to reduce potentially detrimental psychiatric hospitalization could include preventative monitoring program psychoeducation comprising accurate risk assessment and preparation of 24-hour crisis intervention programs to provide immediate psychiatric support and treatment. The former was associated with a host of better patient outcomes and experiences, including lower levels of perceived coercion and distress and higher levels of optimism.…”