Family expectations of inpatient mental health services for adults with suicidal ideation: a qualitative study

Abstract

Involvement of family members of adults with suicidal ideation is a key area of improvement in inpatient mental health services. To support family involvement in this context, it is crucial to understand what care and treatment family members expect for their relative. This qualitative study based on grounded theory involved interviews with 14 family members, including partners, parents, adult children and siblings. The family members' expectations of care and treatment in inpatient mental health services were captured by the core element 'Struggling to remain hopeful while looking through the lens of uncertainty'. This core element interacted with four sub-elements: assuming safety as a priority, looking for a healing approach and environment, counting on continuity of care and wanting to be involved and supported. The family members fluctuated between hope and uncertainty depending on whether their expectations were met or unmet. Unmet expectations were common and underpinned by a sense of being marginalized during the admission of their relative with suicidal ideation. Mental health professionals, including nurses, can be more empathetic towards the family members and attuned to their expectations. This can underpin partnerships that help families to deal with their feelings of uncertainty and disempowerment. Such partnerships can flourish in recovery-oriented mental health services that allow meaningful family involvement.

Nursing handover involving consumers on inpatient mental healthcare units: A qualitative exploration of the consumers’ perspective

“…The way of recruiting participants was in line with positive experiences from previous research by Vandewalle et al . (2021a, 2021b).…”

Caring for a friend or family member who has experienced suicidal behaviour: A systematic review and qualitative synthesis

“…A study conducted in Ghana (Asare-Doku et al, 2017) identified social support as a coping resource for mothers, but not fathers, interpreted by the author as evidence of gendered responses to suicidal behaviour within the family. Some carers had sought professional emotional support, primarily in the form of individual counselling (Garcia-Williams & McGee, 2016;Nosek, 2008;Nygaard et al, 2019;Vandewalle et al, 2021;Wolk-Wasserman, 1987a) while others identified personal professional emotional support as an unresolved support need (Dransart & Guerry, 2017;Inscoe et al, 2021;Ngwane & van Der Wath, 2019;Wolk-Wasserman, 1987b).…”

“…Indeed, regarding hospital admission, one carer noted: 'I am always restless and anxious, at home, at work… and then his admission created a moment of rest, to take some time off for myself. Because I knew: they will take care of him' (Vandewalle et al, 2021(Vandewalle et al, , p. 1142.…”

“…Other consequences of limited communication with health professionals included feelings of guilt about the inadequacy of carers' own actions (Ngwane & van Der Wath, 2019;Vandewalle et al, 2021) and a sense of being an informant rather than a partner in care (Dransart & Guerry, 2017;Vandewalle et al, 2021;Wolk-Wasserman, 1987b). One carer described this as 'a feeling of not being listened to, of not knowing where to go, whom to reach out to, how to find help…we are alone, powerless, we don't know what to do' (Dransart & Guerry,p.…”

“…6). Some carers were dejected by the inability of staff to factor their understanding of the situation into the care offered to service users (Dransart & Guerry, 2017;Fu et al, 2021;Sellin et al, 2017;Talseth et al, 2001;Vandewalle et al, 2021;Wolk-Wasserman, 1987a):…”