‘In some ways it all helps but in some ways it doesn't’: The complexities of service users’ experiences of inpatient mental health care in Australia

Abstract

Recovery-oriented mental health care requires active involvement of service users in the evaluation of care. While experience of care surveys is routinely given out upon discharge, capturing the depth and detail of service users' experiences in such a way to meaningfully improve services may require more in-depth and targeted approaches. This study aimed to gather voluntary and involuntary service users' experiences of care during hospitalization in two acute adult mental health inpatient units, through the collaborative completion of a purpose designed tool. The purpose of the study was to examine broad experiences of care and to identify the utility of proactive approaches to ongoing service evaluation. Overall, 67 participants were interviewed. Findings highlight the complexity of experiences of care including how an admission can seemingly facilitate clinical recovery while not being recovery-oriented. The findings also detail areas for improvement in the way that care is delivered and evaluated. The implications are particularly pertinent for mental health nurses to consider how, within the existing constraints of their roles, they can provide therapeutic care to all service users.

It's a little bit like prison, but not that much: Aboriginal women's experiences of an acute mental health inpatient unit.

“…Women's responses in this study showed that the inpatient unit can be ambiguous, both an unsafe and a safe space, potentially both therapeutic and traumatizing. This finding supports reported outcomes of previous studies of inpatient milieux nationally and internationally (Isobel 2019; Muir‐Cochrane et al . 2012).…”

“…Women's responses in this study showed that the inpatient unit can be ambiguous, both an unsafe and a safe space, potentially both therapeutic and traumatizing. This finding supports reported outcomes of previous studies of inpatient milieux nationally and internationally (Isobel 2019;Muir-Cochrane et al 2012). It is a space permeable to social and cultural influences on both clinicians and service users, its possibilities mediated by unit philosophies and practices and the persona of individual clinicians (Kanerva et al 2013).…”

“…Themes described in this research are not exclusive to Aboriginal women. Indeed they reflect experiences and concerns voiced by inpatients throughout the recorded literature, regardless of ethnicity, gender, age, or social status (Andreasson & Skarsater 2012;Fletcher et al 2019;Isobel 2019;Kennedy et al 2019). This basic universality of experience is, however, overlaid with a strong, living cultural actuality that is unique to each woman.…”

“…Indeed they reflect experiences and concerns voiced by inpatients throughout the recorded literature, regardless of ethnicity, gender, age, or social status (Andreasson & Skarsater 2012; Fletcher et al . 2019; Isobel 2019; Kennedy et al . 2019).…”

Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study

“…As a result, admission to an acute unit is often oriented towards risks to physical safety such as suicide, self‐harm, substance misuse or aggression (Berzins, Baker, Brown, & Lawton, 2018). While many consumers describe feeling physically safe in acute units, others describe their emotional and psychological safety as being compromised in this setting (Isobel, 2019). Indeed, limited focus is given to consumers' emotional or psychological safety needs in acute units (Stenhouse, 2013).…”