Post‐discharge needs of Iranian women diagnosed with severe mental illness: A qualitative study

Abstract

Accessible Summary What is known on the subject? A search of common databases indicates the absence of any research focused on the needs of Iranian women diagnosed with severe mental illness post‐discharge from an inpatient setting. Moreover, there is a lacuna of information about the unique experiences and needs of persons diagnosed with severe mental illness living in non‐Western communities (esp. Middle Eastern communities). What this paper adds to existing knowledge This study examined interviews of women diagnosed with severe mental illness receiving treatment at an Iranian inpatient hospital. Three categories of post‐discharge needs emerged: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self‐management skills. Lastly, information distinguished between illness‐related information and women's health information. What are the implications for practice? Findings highlight the need for systemic changes to current care models. Broadly, families should be incorporated into care to improve outcomes and decrease stigma. Regarding mental health nursing, results highlighted the need for additional nursing and occupational therapy interventions to empower families and patients. Nursing practitioners can aid in preparing these patients for employment and public health initiatives to decrease stigma and improve access to care. Abstract IntroductionUnderstanding the post‐discharge needs of patients diagnosed with severe mental illness is critical for improving treatment outcomes. AimThe aim of the present study was to determine the unique post‐discharge needs of Iranian women diagnosed with severe mental illness. MethodConventional content analysis was utilized to analyse data gathered via focus group interviews conducted within the psychiatric inpatient unit at Farabi hospital located in Kermanshah, Iran. Participants (N = 42; M age = 40; SD = 6.3 years) had been diagnosed with a severe mental illness, had a history of at least two psychiatric hospitalizations and were awaiting discharge following significant symptom improvement. ResultsContent analysis extracted three categories of post‐discharge needs: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self‐management skills. Lastly, information distinguished between illness‐related information and women's health information. Discussion/Implications for practiceAnalysis of interview data highlighted the general need for adopting a family‐system approach to reduce stigma, increase knowledge and foster skill acquisition. Regarding mental health nursing, results highlighted the unique role of nurses and their capacity to pre‐emptively address needs such as aiding in employment. Lastly, findings are contrasted against Western care models.

Exploration of the Barriers to Clozapine Prescribing in Patients with Treatment-Resistant Schizophrenia: A Qualitative Study

“…These problems have been repeatedly emphasized in previous studies, such as patients' lack of access to the laboratory, the need to go to other cities for this purpose, the congestion of medical centers as barriers to treatment with clozapine, and changes in the delivery system offered for easier access to these patients (Kelly et al 2018 ; Rezaie et al 2017 ; Muralidharan et al 2019 ). It also seems as Rezaie and Phillips ( 2020 ) have stated that providing information about the drug and its possible side effects can be effective in attracting the patient to cooperate in the regular use of the drug. On the other hand, considering the importance of the role of families in the treatment process of psychiatric patients, paying attention to their needs in receiving information and other mental health services can reduce burden of care for them and reduce their concerns and cooperation in the treatment process (Reupert et al 2015 ; Rezaie et al 2019 ).…”

Triangulation study of needs assessment of people with severe mental illness in “follow‐up” day hospital settings

“…DH is expected to link them to vocational rehabilitation and employment services as well as with services to enable them to complete their education. Mental health nurses might have a role in supporting vocational rehabilitation (Jackel et al, 2020 ; Rezaie & Phillips, 2020 ). Hasegawaa et al ( 2018 ) suggest that chances for future employment can be promoted through improvements in social functioning during early‐stage treatment.…”

“…DH services might improve knowledge and skills of families regarding coping and cooperation may reduce family member concerns (Jones et al, 2014 ). The systematic family approach also reduces stigma, increases knowledge and fosters skills (Koenders et al, 2017 ; Rezaie & Phillips, 2020 ).…”

Preventing post-discharge suicides in psychiatric patients: insights from patients, lay healthcare supporters, and mental health professionals—a qualitative analysis

“…Thus, it’s important to develop and implement interventions adapted to the context in China. Further, we notice that most interventions are designed or implemented from a top-down approach, rather than being patient-centered, and only a few have considered the problems that patients may face after discharge and their needs [ 46 , 47 ]. Hence, to help develop patient-centered policies and interventions to reduce post-discharge suicide risk among psychiatric patients, this study aims to explore problems faced by patients after discharge and their needs from the perspectives of patients and lay healthcare supporters who are usually patients’ family members and friends.…”