‘Responsible, but Still not a Real Treatment Partner’: A Qualitative Study of the Experiences of Relatives of Patients on Outpatient Commitment Orders

Stensrud, Bjørn; Høyer, Georg; Granerud, Arild; Landheim, Anne

doi:10.3109/01612840.2015.1021939

Cited by 21 publications

(22 citation statements)

References 32 publications

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“…Many perceive their involvement as potentially contributing to how CTOs work, particularly through providing everyone involved with the right information at the right time. Some said the CTO has led to increased involvement and influence over decisions, and this is also reported in other studies [ 4 , 14 , 16 , 18 ]. However, many carers also experience being excluded, inadequately consulted, having their views ignored, or receiving insufficient information, including legal documents.…”

Section: Discussionsupporting

confidence: 61%

“…However, many carers also experience being excluded, inadequately consulted, having their views ignored, or receiving insufficient information, including legal documents. Again, this is reflected in international studies [ 4 , 5 , 14 , 16 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most indicated that carers in general welcome CTOs insofar as they facilitate support to the patient. Carers, along with patients and psychiatrists, see the key justification for CTOs as obliging patients to take medication and to stay in contact with services [ 13 , 14 ]. Some studies include information on carer involvement in CTO.…”

Section: Introductionmentioning

confidence: 99%

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Carer involvement in compulsory out-patient psychiatric care in England

Rugkåsa

Canvin

2017

BMC Health Serv Res

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BackgroundThere is an expectation in current heath care policy that family carers are involved in service delivery. This is also the case with compulsory outpatient mental health care, Community Treatment Orders (CTOs) that were introduced in England in 2008. No study has systematically investigated family involvement through the CTO process.MethodWe conducted qualitative interviews with 24 family carers to ascertain their views and experiences of involvement in CTOs. The transcripts were subjected to thematic analysis that incorporated both deductive and inductive elements.ResultsWe found significant variation in both the type and extent of family carer involvement throughout the CTO process (initiation, recall to hospital, renewal, tribunal hearings, discharge). Some were satisfied with their level of involvement while others felt (at least partly) excluded or that they wanted to be more involved. Some wanted less involvement than what they had. From the interviews we identified key factors shaping carers' involvement. These included: perceptions of patient preference; concern over the relationship to the patient; carers’ knowledge of the CTO and of the potential for carer involvement; access to and relationships with health professionals; issues of patient confidentiality; opportunities for private discussions, and; health professionals limiting involvement. These factors show that health professionals have many opportunities to facilitate, or hinder, carer involvement. The various roles attributed to carers, such ‘proxy’ for patient decision, ‘gatekeeper’ to services, ‘mother’ or ‘expert carer’, however, conflict with one another and make the overall role unclear.ConclusionsThere is a need for clarification of the expectations of carers in individual care situations, for carers to be equipped with the information they need to in order to be involved, and for services to find flexible and innovative ways of ensuring continuous, open communication. The introduction of CTOs in England has not been successful in its ambition for carer involvement.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2716-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Carer involvement in compulsory out-patient psychiatric care in England

Rugkåsa

Canvin

2017

BMC Health Serv Res

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“…Some relatives will stay in nearby hotel facilities for the duration of the patient's hospitalization. As relatives’ involvement increases, the need for more information about their participation also has increased …”

Section: Literature Reviewmentioning

confidence: 99%

Patients' Perspectives on Relatives in the Perioperative Setting: A Danish Study

Nors¹,

Sestoft²,

Dreyer³

2020

AORN Journal

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Surgical patients may have doubts about bringing relatives into the perioperative setting because they are unfamiliar with the environment and rules. This study aims to investigate patients' experiences with relatives' participation in this context. We conducted 15 semistructured interviews with surgical patients and analyzed data according to Kvale and Brinkmann's meaning condensation. We found that patients believe they do not have tailored information to prepare themselves and their relatives for surgery. They believe that their individual information is not transferred between health care workers, making them feel unsafe and confused; that control reduces anxiety; and that cooperation among everyone involved in their care creates coherence. We concluded that a collaborative trialogue involving the patient, relatives, and health care workers may benefit all involved. In cooperation, patients can make individual choices about their care, relatives can understand their role and opportunities, and health care workers can tailor the care they provide.

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“…10 Another study of relatives of patients with OC decisions referred to the positive experience of OC providing safety and ensuring functioning in daily life. 11 The mental health service in Norway is organized on two main levels: a specialist health service and a primary care level in the municipality. The specialist health service is divided into hospital and district psychiatric centers (DPCs), which both provide diagnosis and consider coercive decisions.…”

Section: Introductionmentioning

confidence: 99%

Cooperation in the mental health treatment of patients with outpatient commitment

et al. 2020

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Background: Patients with outpatient commitment have a decision on coercive treatment from the specialist health services even if they are in their own home and receive municipal health services. Objective: The aim of this study is to gain more knowledge about how the outpatient commitment system works in the municipal health service and specialist health services, and how they collaborate with patients and across service levels from the perspectives of healthcare professionals. Methods: This is a qualitative study collecting data through focus group interviews with health personnel from the municipal health service and specialist health services. Results: The results describe the health personnel’s experiences with follow-up and interactions with the patients with outpatient commitment decisions, and their experiences with collaboration between service levels. Conclusion: The study show that outpatient commitment makes a difference in the way patients with this decision are followed up. The legislative amendment with new requirements for consent competence was challenging. Collaboration between services levels was also challenging.

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‘Responsible, but Still not a Real Treatment Partner’: A Qualitative Study of the Experiences of Relatives of Patients on Outpatient Commitment Orders

Cited by 21 publications

References 32 publications

Carer involvement in compulsory out-patient psychiatric care in England

Carer involvement in compulsory out-patient psychiatric care in England

Patients' Perspectives on Relatives in the Perioperative Setting: A Danish Study

Cooperation in the mental health treatment of patients with outpatient commitment

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