Family Involvement in Psychiatric Hospitalizations: Associations With Discharge Planning and Prompt Follow-Up Care

Haselden, Morgan; Corbeil, Tom; Tang, Fei; Olfson, Mark; Dixon, Lisa B.; Essock, Susan M.; Wall, Melanie M.; Radigan, Marleen; Frimpong, Eric; Wang, Rui; Lamberti, Steven; Schneider, Mark; Smith, Thomas E.

doi:10.1176/appi.ps.201900028

Cited by 22 publications

(13 citation statements)

References 10 publications

(14 reference statements)

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“…13 In special populations known to have heightened risk for suicide, such as military veterans who use Department of Veterans Affairs (VA) services, evidence also suggests that social support is protective against suicide risk. 14 Much of the research on the role and impact of close supports has focused on relatively simple actions and behaviors that close supports can undertake, such as co-attendance of routine medical visits, 15 participation in discharge planning, 16 or medication reminders. 17 Relatively little is understood about some of the more complex aspects of how close supports might be effective in supporting their loved ones with depression.…”

Section: Introductionmentioning

confidence: 99%

The Importance of “Being There”: a Qualitative Study of What Veterans with Depression Want in Social Support

et al. 2020

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Background: Social connectedness exerts strong influences on health, including major depression and suicide. A major component of social connectedness is having individual relationships with close supports, romantic partners and other trusted members of one's social network. Objective: The objective of this study was to understand how individuals' relationships with close supports might be leveraged to improve outcomes for primary care patients with depression and at risk for suicide. Design: In this qualitative study, a semi-structured interview guide was used to probe patient experiences, views, and preferences related to social support. Participants: We conducted interviews with 30 primary care patients at a Veterans Health Administration (VA) medical center who had symptoms of major depression and a close support. Approach: Thematic analysis of qualitative interview data examined close supports' impact on patients. We iteratively developed a codebook, used output from codes to sort data into themes, and selected quotations that exemplified themes for inclusion in this manuscript. Key Results: "Being there" as an important quality of close supports emerged as a key concept. "Being there" was defined in three ways: physical proximity, frequent or responsive contact, or perceived availability. Close supports who were effective at "being there" possessed skills in intuitively sensing the patient's emotional state and communicating indirectly about depression. Three major barriers to involving close supports in depression care were: concerns of overburdening the close support, a perception that awareness of the patient's depression would make the close support unnecessarily worried, and a desire and preference among patients to handle depression on their own. Conclusions: "Being there" represents a novel, patient-generated way to conceptualize and talk about social support. Suicide prevention initiatives such as population-level communication campaigns might be improved by incorporating language used by patients and addressing attitudinal barriers to allowing help and involvement close supports.

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Section: Introductionmentioning

confidence: 99%

The Importance of “Being There”: a Qualitative Study of What Veterans with Depression Want in Social Support

et al. 2020

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“…There was a global consensus on the role of efficient discharge planning and the capacities of outpatient and residential services for the capacity planning of inpatient mental health facilities [ 33 , 34 ]. The quality and standards of mental health care were a major concern, especially in LMICs, probably reflecting the concern for minimum standards of care that apart from the physical infrastructure of the bed also lack sufficient human resources, availability of medication and equipment to run existing facilities [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Minimum and optimal numbers of psychiatric beds: expert consensus using a Delphi process

et al. 2022

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The required minimum number of psychiatric inpatient beds is highly debated and has substantial resource implications. The present study used the Delphi method to try to reach a global consensus on the minimum and optimal psychiatric bed numbers. An international board of scientific advisors nominated the Delphi panel members. In the first round, the expert panel provided responses exploring estimate ranges for a minimum to optimal numbers of psychiatric beds and three levels of shortage. In a second round, the panel reconsidered their responses using the input from the total group to achieve consensus. The Delphi panel comprised 65 experts (42% women, 54% based in low- and middle-income countries) from 40 countries in the six regions of the World Health Organization. Sixty psychiatric beds per 100 000 population were considered optimal and 30 the minimum, whilst 25–30 was regarded as mild, 15–25 as moderate, and less than 15 as severe shortage. This is the first expert consensus on minimum and optimal bed numbers involving experts from HICs and LMICs. Many high-income countries have psychiatric bed numbers that fall within the recommended range. In contrast, the number of beds in many LMIC is below the minimum recommended rate.

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“…Consistent with those reported from previous research, our findings suggest that actively involving families and carers in a patient's mental healthcare may contribute to improved outcomes. 7,8,[23][24][25][26] Despite national guidelines recommending the involvement of the family or carers, routine implementation is inconsistent. 6,13,14,27,28 Our findings suggest that this may in part be due to challenges in two key areas.…”

Section: Comparisons With Existing Literaturementioning

confidence: 99%

Family involvement, patient safety and suicide prevention in mental healthcare: ethnographic study

et al. 2023

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Background Family involvement has been identified as a key aspect of clinical practice that may help to prevent suicide. Aims To investigate how families can be effectively involved in supporting a patient accessing crisis mental health services. Method A multi-site ethnographic investigation was undertaken with two crisis resolution home treatment teams in England. Data included 27 observations of clinical practice and interviews with 6 patients, 4 family members, and 13 healthcare professionals. Data were analysed using framework analysis. Results Three overarching themes described how families and carers are involved in mental healthcare. Families played a key role in keeping patients safe by reducing access to means of self-harm. They also provided useful contextual information to healthcare professionals delivering the service. However, delivering a home-based service can be challenging in the absence of a supportive family environment or because of practical problems such as the lack of suitable private spaces within the home. At an organisational level, service design and delivery can be adjusted to promote family involvement. Conclusions Findings from this study indicate that better communication and dissemination of safety and care plans, shared learning, signposting to carer groups and support for carers may facilitate better family involvement. Organisationally, offering flexible appointment times and alternative spaces for appointments may help improve services for patients.

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Family Involvement in Psychiatric Hospitalizations: Associations With Discharge Planning and Prompt Follow-Up Care

Abstract: Involving family in the care of inpatients with serious mental illness is known to be beneficial. This study examined frequencies of involvement by family in the care and discharge planning for 179 psychiatric inpatients.

Cited by 22 publications

References 10 publications

The Importance of “Being There”: a Qualitative Study of What Veterans with Depression Want in Social Support

The Importance of “Being There”: a Qualitative Study of What Veterans with Depression Want in Social Support

Minimum and optimal numbers of psychiatric beds: expert consensus using a Delphi process

Family involvement, patient safety and suicide prevention in mental healthcare: ethnographic study

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