Patients’ subjective perspective on recovery orientation on an acute psychiatric unit

Jaeger, M.; Konrad, Albrecht; Rueegg, Sebastian; Rabenschlag, Franziska

doi:10.3109/08039488.2014.959561

Cited by 14 publications

(18 citation statements)

References 42 publications

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“…25 Consumers' and their supporters' perspectives regarding strategies for reducing or eliminating seclusion and restraint share similar concerns to those reported in previous research. [21][22][23][24] These findings reinforce the emphasis on the need for accountability and the value of providing peer support and enabling the involvement of supporters. These strategies have the potential to assist with the policy direction in Australia of working towards the elimination of seclusion and restraint and are in need of further exploration.…”

Section: Resultsmentioning

confidence: 58%

“…As the recovery focus has grown in mental health care, the means of increasing recovery orientation in acute in-patient settings are emerging in the literature. 21 However, these findings suggest that introducing more recovery-oriented service delivery is challenging when coercive practice is supported by workplace culture.…”

Section: Discussionmentioning

confidence: 87%

“…24 Implicit barriers to the reduction of coercive practices also need to be addressed to ensure trauma, stigma and discrimination are acknowledged and addressed. 21 …”

Section: Discussionmentioning

confidence: 99%

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Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Brophy

Roper²,

Hamilton

et al. 2016

Aust. Health Review

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Objective. This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings.Methods. Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.Results. All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes.Conclusions. Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices.What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies. What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature.

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Section: Resultsmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 87%

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Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Brophy

Roper²,

Hamilton

et al. 2016

Aust. Health Review

View full text Add to dashboard Cite

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“…The hypothesis that length of hospital stay would be shorter the more patients participated in treatment decisions and care planning has been tested. 122,134 Interestingly, no significant relationship between increased involvement and length of stay across a mixed population of inpatients has been found. 122 However, a relationship between increased patient involvement, length of stay and severity of illness has been noted.…”

Section: Discharge and Readmissionmentioning

confidence: 98%

“…109,113 l Care plans did not reflect patient involvement in decision-making or patient-identified goals. [114][115][116][117][118][119][120][121][122] l There is a lack of carer/family involvement in care planning and a lack of recognition and appreciation of their role from health professionals. 112,115,123 Several issues are identified that affect user involvement and participation in care planning decision-making, including the following.…”

Section: Policy Analysis and Literature Reviewmentioning

confidence: 99%

Cross-national mixed-methods comparative case study of recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings (COCAPP-A)

Simpson

Coffey

Hannigan

et al. 2017

Health Serv Deliv Res

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BackgroundMental health service users in acute inpatient wards, whether informal or detained, should be involved in planning and reviewing their care. Care planning processes should be personalised and focused on recovery, with goals that are specific to the individual and designed to maximise their achievements and social integration.Objective(s)We aimed to ascertain the views and experiences of service users, carers and staff to enable us to identify factors that facilitated or acted as barriers to collaborative, recovery-focused care and to make suggestions for future research.DesignA cross-national comparative mixed-methods study involving 19 mental health wards in six NHS sites in England and Wales included a metanarrative synthesis of policies and literature; a survey of service users (n = 301) and staff (n = 290); embedded case studies involving interviews with staff, service users and carers (n = 76); and a review of care plans (n = 51) and meetings (n = 12).ResultsNo global differences were found across the sites in the scores of the four questionnaires completed by service users. For staff, there was significant difference between sites in mean scores on recovery-orientation and therapeutic relationships. For service users, when recovery-orientated focus was high, the quality of care was viewed highly, as was the quality of therapeutic relationships. For staff, there was a moderate correlation between recovery orientation and quality of therapeutic relationships, with considerable variability. Across all sites, staff’s scores were significantly higher than service users’ scores on the scale to assess therapeutic relationships. Staff across the sites spoke of the importance of collaborative care planning. However, the staff, service user and carer interviews revealed gaps between shared aspirations and realities. Staff accounts of routine collaboration contrasted with service user accounts and care plan reviews. Definitions and understandings of recovery varied, as did views of the role of hospital care in promoting recovery. ‘Personalisation’ was not a familiar term, although there was recognition that care was often provided in an individualised way. Managing risk was a central issue for staff, and service users were aware of measures taken to keep them safe, although their involvement in discussions was less apparent.ConclusionsOur results suggest that there is positive practice taking place within acute inpatient wards, with evidence of widespread commitment to safe, respectful, compassionate care. Although ideas of recovery were evident, there was some uncertainty about and discrepancy in the relevance of recovery ideals to inpatient care and the ability of people in acute distress to engage in recovery-focused approaches. Despite the fact that staff spoke of efforts to involve them, the majority of service users and carers did not feel that they had been genuinely involved, although they were aware of efforts to keep them safe.Future workFuture research should investigate approaches that increase contact time with service users and promote personalised, recovery-focused working; introduce shared decision-making in risk assessment and management; and improve service user experiences of care planning and review and the use of recovery-focused tools during inpatient care.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Principles for Recovery-Oriented Inpatient Care

Davidson

Carr

Bellamy

et al. 2016

Evidence-Based Practices in Behavioral Health

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Patients’ subjective perspective on recovery orientation on an acute psychiatric unit

Cited by 14 publications

References 42 publications

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settings

Cross-national mixed-methods comparative case study of recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings (COCAPP-A)

Principles for Recovery-Oriented Inpatient Care

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