Self-Reported Needs for Care, Support and Treatment of Persons Who Frequently Visit Psychiatric Emergency Rooms in Sweden

Abstract

To meet the needs of persons who frequently visit PERs, close cooperation between concerned welfare actors should be implemented.

Professionals’ Perspective on Needs of Persons Who Frequently Use Psychiatric Emergency Services

“…The main finding is that the PES professionals report a complex picture of the patients' needs based on their personal and social life circumstances and on the healthcare and support context. The needs identified by the professionals correspond relatively well with those expressed by persons who frequently visit PES or emergency departments themselves Schmidt et al, 2018b;Vandyk et al, 2018Vandyk et al, , 2019Wise-Harris et al, 2017), stressing the complexity of the patients' needs and the subjective component of the patients' suffering, lack of health and well-being, and the need for human contact and social interaction. In particular, the patients' feelings of loneliness, their internal and external struggle, and their negative self-image leading to feelings of worthlessness and hopelessness were common topics discussed in studies about persons with (severe) mental illness visiting other mental health or healthcare services (Ådnøy Eriksen, Sundfør, Karlsson, Råholm, & Arman, 2012;Fleury, Grenier, Bamvita, & Tremblay, 2013;Lindgren, Sundbaum, Eriksson, & Graneheim, 2014).…”

“…What problems do they have?"). Each individual interview started by referring to one of the most common definitions of frequent PES visitors as persons with at least five contacts within a 12-month period (Aagaard et al, 2014;Blonigen et al, 2017;Schmidt et al, 2018b).…”

“…Healthcare professionals working at PES play an important role in providing multifaceted services to persons who frequently use PES. These professionals have been described as an integrated and valued part of the social networks of persons who frequently visit PES, providing them with safety and security (Aagaard et al, 2014;Barker & Buchanan-Barker, 2010;Schmidt, Ekstrand, & Bengtsson Tops, 2018b). Given their numerous encounters with and extensive knowledge of these patients, healthcare professionals might represent a valuable source of information regarding their needs.…”

“…Persons who frequently visit PES have been shown to have complex and multifaceted needs (cf. Fleury, Grenier, Farand, & Ferland, 2019;Schmidt et al, 2018b), some of which may remain unmet if people have difficulties expressing them in the first place. Compounding this challenge may be the fact that persons who frequently visit PES are a heterogeneous group that varies greatly in diagnostic profile, socioeconomic characteristics, and temporal utilization patterns (Schmidt et al, 2018a).…”

“…Compounding this challenge may be the fact that persons who frequently visit PES are a heterogeneous group that varies greatly in diagnostic profile, socioeconomic characteristics, and temporal utilization patterns (Schmidt et al, 2018a). In a recent Swedish mixedmethods study including persons who frequently visit PES, the participants self-reported having needs to reduce acute suffering, feel secure, and have caring encounters with PES staff, as well as needs to reduce psychological distress and psychotic symptoms and to have daytime activities (Schmidt et al, 2018b). Reviews of studies focusing on persons who frequently visit PES or emergency departments, and on their needs in particular, indicated that explanatory research has dominated the field so far (Schmidt, 2018;Vandyk, Harrison, VanDenKerkhof, Graham, & Ross-White, 2013), while exploratory research has been scarce (Vandyk, Bentz, Bissonette, & Cater, 2019;Vandyk, Young, MacPhee, & Gillis, 2018;Wise-Harris et al, 2017).…”