Life on the psychiatric ward: a qualitative study (original) (raw)
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Psychiatric Bulletin
BMJ open, 2018
This paper provides an in-depth account of general practitioners' (GPs) experiences of living and working with mental illness and distress, as part of a wider study reporting the barriers and facilitators to help-seeking for mental illness and burn-out, and sources of stress/distress for GP participants. Qualitative study using in-depth interviews with 47 GP participants. The interviews were audio recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method. England. A purposive sample of GP participants who self-identified as: (1) currently living with mental distress, (2) returning to work following treatment, (3) off sick or retired early as a result of mental distress or (4) without experience of mental distress. Interviews were conducted face to face or over the telephone. The findings report GP participants' in-depth experiences of distress and mental...
Psychiatric Bulletin, 2009
SummaryTwo recent articles, ‘The trouble with NHS psychiatry in England’ and ‘Wake-up call for British psychiatry’ have levelled severe criticisms against the NHS provider systems for people with mental disorders. In response, we argue that such severe criticisms are not fully justified. We propose that there are six areas for debate: ideological matters, policy intentions, empirical questions, operational issues and professional activities. Under this simple six-point taxonomy it might be possible to have a more sophisticated debate about how all parties should work together to achieve the best outcomes for patients.
What do we know about life on acute psychiatric wards in the UK? a review of the research evidence
Social Science & Medicine, 2001
Despite the development of community care and associated processes of de-institutionalisation, the hospital remains the hub of mental health services in the UK. However, previous quantitative and survey research indicates that quality of care in acute psychiatric (admission) wards has been compromised or is under threat, and points to a bleak experience for people who are admitted. Indicators of this include that there have been increases in admission rates, the proportion of compulsory admissions, and bed occupancy rates. There is also evidence of violence, sexual harassment and substance misuse in this setting, accompanied by rapid staff turnover, low staff morale, and an increasing proportion of 'difficult' patients (especially young men with schizophrenia). This paper reviews the evidence about life on psychiatric wards, focusing on how it is experienced by patients in acute settings. Research conducted in the UK in the 1990s, supports the impression that organisational pressures are having a negative impact on the quality of care. It shows that: nurse-patient (N-P) relationships are perceived to be an important aspect of care, but that N-P contact has declined; and patients are critical of conditions on the ward and view life there as both boring and unsafe. However, very little in-depth ethnographic research has been conducted on acute wards in the UK (and none since the 1970s) leaving us with a 'black box' view of in-patient care in this setting. Studies conducted during earlier 'care paradigms', notably those in the USA by Goffman and Strauss et al., provide useful insights into the patient's experience, but the extent to which these can be conceptually generalised to the present situation is unknown. The paper concludes by outlining questions and priorities for future investigation, focusing on the role of qualitative research. #
Caring for mental health service users on a general ward: a phenomenological approach
International Journal of Healthcare Sciences, 2020
Caring for mental health service users is a public concern especially in situations where these types of patients have to be managed in a general ward. Government is committed to establish measures that would enhance the standard of caring for mental health service users in a general ward setting. This study intended to explore and describe the lived experiences of nurses who care for the mental health service users in public hospital in Libode in the Eastern Cape Province in South Africa. A qualitative, descriptive phenomenological research design to explore and describe the lived experiences of nurses who care for the mental health care users in general wards at a district hospital. Semi-structured individual interviews (n =6) were used to collect data from the se nurses. These interviews were audio-taped and transcribed verbatim and Collaizzi's process of qualitative data analysis was applied for data analysis. This study reported both positive and negative experiences. Positive experiences included the rescue of mental health care users and cooperation among nurses. Negative experiences included the combination of chronic ill patients with known aggressive and unpredictable mental health care users; shortage of staff; unsecured fencing for mental health care users; lack of support from managers and feeling unappreciated were reported. In conclusion, necessary prioritisation of all aspects of services in the management of mental health care users should be adhered to. Secondly, paying attention to all nurses' needs regarding the circumstances they undergo when managing mental health service users should be adhered to.
BJPsych Open
Background Psychological therapy is core component of mental healthcare. However, many people with severe mental illnesses do not receive therapy, particularly in acute mental health settings. Aims This study identifies barriers to delivering and accessing psychological therapies in acute mental health settings, and is the first to recommend how services can increase access from the perspectives of different stakeholders (staff, patients and carers). Method Sixty participants with experiences of acute mental health wards (26 staff, 22 patients and 12 carers) were interviewed about barriers to accessing therapy in in-patient settings and how therapies should be delivered to maximise access. Results Four themes were identified: (a) ‘Models of care’, including the function of in-patient wards, beliefs about the causes of mental health problems and the importance of strong leadership to support psychosocial interventions; (b) ‘Integrated care’, including the importance of psychologists ...
Life in acute mental health settings: experiences and perceptions of service users and nurses
Epidemiology and Psychiatric Sciences
Background. Acute psychiatric provision in the UK today as well as globally has many critics including service users and nurses. Method. Four focus groups, each meeting twice, were held separately for service users and nurses. The analysis was not purely inductive but driven by concerns with the social position of marginalised groups - both patients and staff. Results. The main themes were nurse/patient interaction and coercion. Service users and nurses conceptualised these differently. Service users found nurses inaccessible and uncaring, whereas nurses also felt powerless because their working life was dominated by administration. Nurses saw coercive situations as a reasonable response to factors 'internal' to the patient whereas for service users they were driven to extreme behaviour by the environment of the ward and coercive interventions were unnecessary and heavy handed. Conclusion. This study sheds new light on living and working in acute mental health settings today...
Social Psychiatry and Psychiatric Epidemiology, 2014
Purpose Throughout the past 50 years mental health services have aimed to provide and improve high quality inpatient care. It is not clear whether there has been improvement as service users and nursing staff have both expressed frustration at the lack of therapeutic activities. In particular, it may be that the changing levels of symptoms over the past 50 years may affect engagement with ward activities. Methods Eight wards in a health care trust in London serving an inner city and urban populations participated. Data were collected on participation in activities and 116 service users’ perceptions of acute care as well as clinical factors. Results Less time was spent participating in activities today than 50 years ago, while one quarter of service users reported taking part in no activities at all. Uptake of activities was related to more positive service user perceptions of the wards. Symptom severity did not impact the frequency of participation in activities, although those who took part in no activities at all had higher negative symptoms scores. Conclusions Service users’ uptake of activities was not related to the severity of their illness. This belies the belief that the acutely ill cannot take part in meaningful activities. This study supports the view that more therapeutic activities could be taken up by the acutely ill and are in fact appreciated.