TY - JOUR
T1 - Experiences of in-patient mental health services: systematic review
AU - Staniszewska, Sophie
AU - Mockford, Carole
AU - Chadburn, Greg
AU - Fenton, Sarah-jane Hannah
AU - Bhui, Kamaldeep S.
AU - Larkin, Michael
AU - Newton, Elizabeth
AU - Crepaz-keay, David
AU - Griffiths, Frances
AU - Weich, Scott
N1 - The final publication is available via Cambridge Journals Online at http://dx.doi.org/10.1192/bjp.2019.22
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background In-patients in crisis report poor experiences of mental healthcare not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support. There is little high-quality evidence on what is important to patients to inform recovery-focused care.Aims To conduct a systematic review of published literature, identifying key themes for improving experiences of in-patient mental healthcare.Method A systematic search of online databases (MEDLINE, PsycINFO and CINAHL) for primary research published between January 2000 and January 2016. All study designs from all countries were eligible. A qualitative analysis was undertaken and study quality was appraised. A patient and public reference group contributed to the review.Results Studies (72) from 16 countries found four dimensions were consistently related to significantly influencing in-patients' experiences of crisis and recovery-focused care: the importance of high-quality relationships; averting negative experiences of coercion; a healthy, safe and enabling physical and social environment; and authentic experiences of patient-centred care. Critical elements for patients were trust, respect, safe wards, information and explanation about clinical decisions, therapeutic activities, and family inclusion in care.Conclusions A number of experiences hinder recovery-focused care and must be addressed with the involvement of staff to provide high-quality in-patient services. Future evaluations of service quality and development of practice guidance should embed these four dimensions.Declaration of interest K.B. is editor of British Journal of Psychiatry and leads a national programme (Synergi Collaborative Centre) on patient experiences driving change in services and inequalities.
AB - Background In-patients in crisis report poor experiences of mental healthcare not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support. There is little high-quality evidence on what is important to patients to inform recovery-focused care.Aims To conduct a systematic review of published literature, identifying key themes for improving experiences of in-patient mental healthcare.Method A systematic search of online databases (MEDLINE, PsycINFO and CINAHL) for primary research published between January 2000 and January 2016. All study designs from all countries were eligible. A qualitative analysis was undertaken and study quality was appraised. A patient and public reference group contributed to the review.Results Studies (72) from 16 countries found four dimensions were consistently related to significantly influencing in-patients' experiences of crisis and recovery-focused care: the importance of high-quality relationships; averting negative experiences of coercion; a healthy, safe and enabling physical and social environment; and authentic experiences of patient-centred care. Critical elements for patients were trust, respect, safe wards, information and explanation about clinical decisions, therapeutic activities, and family inclusion in care.Conclusions A number of experiences hinder recovery-focused care and must be addressed with the involvement of staff to provide high-quality in-patient services. Future evaluations of service quality and development of practice guidance should embed these four dimensions.Declaration of interest K.B. is editor of British Journal of Psychiatry and leads a national programme (Synergi Collaborative Centre) on patient experiences driving change in services and inequalities.
KW - In-patient
KW - experiences
KW - mental health services
KW - systematic review
UR - https://www.cambridge.org/core/product/identifier/S0007125019000229/type/journal_article
UR - http://www.scopus.com/inward/record.url?scp=85065774422&partnerID=8YFLogxK
U2 - 10.1192/bjp.2019.22
DO - 10.1192/bjp.2019.22
M3 - Review article
SN - 0007-1250
VL - 214
SP - 329
EP - 338
JO - British Journal of Psychiatry
JF - British Journal of Psychiatry
IS - 6
ER -