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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Like a hotel, but boring: users’ experience with short-time community-based residential aftercare

Authors: Eirik Roos, Ottar Bjerkeset, Margrét Hrönn Svavarsdóttir, Aslak Steinsbekk

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

The discharge process from hospital to home for patients with severe mental illness (SMI) is often complex, and most are in need of tailored and coordinated community services at home. One solution is to discharge patients to inpatient short-stay community residential aftercare (CRA). The aim of this study was to explore how patients with SMI experience a stay in CRA established in a City in Central Norway.

Methods

A descriptive qualitative study with individual interviews and a group interview with 13 persons. The CRA aims to improve the discharge process from hospital to independent supported living by facilitating the establishment of health and social services and preparing the patients. The philosophy is to help patients use community resources by e.g. not offering any organized in-house activities. The main question in the interviews was “How have you experienced the stay at the CRA?” The interviews were analyzed with a thematic approach using systematic text condensation.

Results

The participants experienced the stay at the CRA “Like a hotel” but also boring, due to the lack of organized in-house activities. The patients generally said they were not informed about the philosophy of the CRA before the stay. The participants had to come up with activities outside the CRA and said they got active help from the staff to do so; some experienced this as positive, whereas others wanted more organized in-house activities like they were used to from mental health hospital stays. Participants described the staff in the CRA to be helpful and forthcoming, but they did not notice the staff being active in organizing the aftercare.

Conclusions

The stay at the CRA was experienced as different from other services, with more freedom and focus on self-care, and lack of in-house activities. This led to increased self-activity among the patients, but some wanted more in-house activities. To prepare the patients better for the stay at the CRA, more information about the philosophy is needed in the pre-admission process.
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Literature
1.
go back to reference Tulloch AD, Fearon P, David AS. Length of stay of general psychiatric inpatients in the United States: systematic review. Admin Pol Ment Health. 2011;38(3):155–68.CrossRef Tulloch AD, Fearon P, David AS. Length of stay of general psychiatric inpatients in the United States: systematic review. Admin Pol Ment Health. 2011;38(3):155–68.CrossRef
2.
go back to reference Irmiter C, McCarthy JF, Barry KL, Soliman S, Blow FC. Reinstitutionalization following psychiatric discharge among VA patients with serious mental illness: a national longitudinal study. Psychiatry Q. 2007;78(4):279–86.CrossRef Irmiter C, McCarthy JF, Barry KL, Soliman S, Blow FC. Reinstitutionalization following psychiatric discharge among VA patients with serious mental illness: a national longitudinal study. Psychiatry Q. 2007;78(4):279–86.CrossRef
3.
go back to reference Mojtabai R, Fochtmann L, Chang S-W, Kotov R, Craig TJ, Bromet E. Unmet need for mental health care in schizophrenia: an overview of literature and new data from a first-admission study. Schizophr Bull. 2009;35(4):679–95.CrossRefPubMedPubMedCentral Mojtabai R, Fochtmann L, Chang S-W, Kotov R, Craig TJ, Bromet E. Unmet need for mental health care in schizophrenia: an overview of literature and new data from a first-admission study. Schizophr Bull. 2009;35(4):679–95.CrossRefPubMedPubMedCentral
4.
go back to reference Mikkelsen EN, Petersen A, Kaae AM, Petersen H. Cross-sector problems of collaboration in psychiatry. Danish medical journal. 2013;60(9):A4707.PubMed Mikkelsen EN, Petersen A, Kaae AM, Petersen H. Cross-sector problems of collaboration in psychiatry. Danish medical journal. 2013;60(9):A4707.PubMed
5.
go back to reference Jones CD, Vu MB, O’Donnell CM, Anderson ME, Patel S, Wald HL, Coleman EA, DeWalt DA. A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations. J Gen Intern Med. 2015;30(4):417–24.CrossRefPubMed Jones CD, Vu MB, O’Donnell CM, Anderson ME, Patel S, Wald HL, Coleman EA, DeWalt DA. A failure to communicate: a qualitative exploration of care coordination between hospitalists and primary care providers around patient hospitalizations. J Gen Intern Med. 2015;30(4):417–24.CrossRefPubMed
6.
go back to reference Couturier B, Carrat F, Hejblum G. A systematic review on the effect of the organisation of hospital discharge on patient health outcomes. BMJ Open. 2016;6(12):e012287.CrossRefPubMedPubMedCentral Couturier B, Carrat F, Hejblum G. A systematic review on the effect of the organisation of hospital discharge on patient health outcomes. BMJ Open. 2016;6(12):e012287.CrossRefPubMedPubMedCentral
7.
go back to reference Shepperd S, McClaran J, Phillips CO, Lannin NA, Clemson LM, McCluskey A, Cameron ID, Barras SL. Discharge planning from hospital to home. Cochrane Database Syst Rev. 2010;1 Shepperd S, McClaran J, Phillips CO, Lannin NA, Clemson LM, McCluskey A, Cameron ID, Barras SL. Discharge planning from hospital to home. Cochrane Database Syst Rev. 2010;1
8.
go back to reference Vigod SN, Kurdyak PA, Dennis CL, Leszcz T, Taylor VH, Blumberger DM, Seitz DP. Transitional interventions to reduce early psychiatric readmissions in adults: systematic review. Br J Psychiatry. 2013;202(3):187–94.CrossRefPubMed Vigod SN, Kurdyak PA, Dennis CL, Leszcz T, Taylor VH, Blumberger DM, Seitz DP. Transitional interventions to reduce early psychiatric readmissions in adults: systematic review. Br J Psychiatry. 2013;202(3):187–94.CrossRefPubMed
9.
go back to reference Pantalon MV, Murphy MK, Barry DT, Lavery M, Swanson AJ. Predictors and moderators of aftercare appointment-keeping following brief motivational interviewing among patients with psychiatric disorders or dual diagnosis. J. of dual diagnosis. 2014;10(1):44–51.CrossRef Pantalon MV, Murphy MK, Barry DT, Lavery M, Swanson AJ. Predictors and moderators of aftercare appointment-keeping following brief motivational interviewing among patients with psychiatric disorders or dual diagnosis. J. of dual diagnosis. 2014;10(1):44–51.CrossRef
10.
go back to reference Forchuk C, MARTIN ML, Chan Y, Jensen E. Therapeutic relationships: from psychiatric hospital to community. J Psychiatr Ment Health Nurs. 2005;12(5):556–64.CrossRefPubMed Forchuk C, MARTIN ML, Chan Y, Jensen E. Therapeutic relationships: from psychiatric hospital to community. J Psychiatr Ment Health Nurs. 2005;12(5):556–64.CrossRefPubMed
11.
go back to reference Lawn S, Smith A, Hunter K. Mental health peer support for hospital avoidance and early discharge: an Australian example of consumer driven and operated service. J Ment Health. 2008;17(5):498–508.CrossRef Lawn S, Smith A, Hunter K. Mental health peer support for hospital avoidance and early discharge: an Australian example of consumer driven and operated service. J Ment Health. 2008;17(5):498–508.CrossRef
12.
go back to reference Rise MB, Evensen GH, Moljord IE, Ro M, Bjorgen D, Eriksen L. How do patients with severe mental diagnosis cope in everyday life - a qualitative study comparing patients’ experiences of self-referral inpatient treatment with treatment as usual? BMC Health Serv Res. 2014;14:347.CrossRefPubMedPubMedCentral Rise MB, Evensen GH, Moljord IE, Ro M, Bjorgen D, Eriksen L. How do patients with severe mental diagnosis cope in everyday life - a qualitative study comparing patients’ experiences of self-referral inpatient treatment with treatment as usual? BMC Health Serv Res. 2014;14:347.CrossRefPubMedPubMedCentral
13.
go back to reference Aagaard J, Freiesleben M, Foldager L. Crisis homes for adult psychiatric patients. Soc Psychiatry Psychiatr Epidemiol. 2008;43(5):403–9.CrossRefPubMed Aagaard J, Freiesleben M, Foldager L. Crisis homes for adult psychiatric patients. Soc Psychiatry Psychiatr Epidemiol. 2008;43(5):403–9.CrossRefPubMed
14.
go back to reference Griswold KS, Zayas LE, Pastore PA, Smith SJ, Wagner CM, Servoss TJ. Primary care after psychiatric crisis: a qualitative analysis. Ann Fam Med. 2008;6(1):38–43.CrossRefPubMedPubMedCentral Griswold KS, Zayas LE, Pastore PA, Smith SJ, Wagner CM, Servoss TJ. Primary care after psychiatric crisis: a qualitative analysis. Ann Fam Med. 2008;6(1):38–43.CrossRefPubMedPubMedCentral
15.
go back to reference Svedberg P, Svensson B, Hansson L, Jormfeldt H. A 2-year follow-up study of people with severe mental illness involved in psychosocial rehabilitation. Nord J Psychiatry. 2014;68(6):401–8.CrossRefPubMed Svedberg P, Svensson B, Hansson L, Jormfeldt H. A 2-year follow-up study of people with severe mental illness involved in psychosocial rehabilitation. Nord J Psychiatry. 2014;68(6):401–8.CrossRefPubMed
16.
go back to reference Bennewith O, Evans J, Donovan J, Paramasivan S, Owen-Smith A, Hollingworth W, Davies R, O'Connor S, Hawton K, Kapur N, et al. A contact-based intervention for people recently discharged from inpatient psychiatric care: a pilot study. Arch Suicide Res. 2014;18(2):131–43.CrossRefPubMed Bennewith O, Evans J, Donovan J, Paramasivan S, Owen-Smith A, Hollingworth W, Davies R, O'Connor S, Hawton K, Kapur N, et al. A contact-based intervention for people recently discharged from inpatient psychiatric care: a pilot study. Arch Suicide Res. 2014;18(2):131–43.CrossRefPubMed
17.
go back to reference Keogh B, Callaghan P, Higgins A. Managing preconceived expectations: mental health service users experiences of going home from hospital: a grounded theory study. J Psychiatr Ment Health Nurs. 2015;22(9):715–23.CrossRefPubMed Keogh B, Callaghan P, Higgins A. Managing preconceived expectations: mental health service users experiences of going home from hospital: a grounded theory study. J Psychiatr Ment Health Nurs. 2015;22(9):715–23.CrossRefPubMed
18.
go back to reference Frick U, Frick H, Langguth B, Landgrebe M, Hubner-Liebermann B, Hajak G. The revolving door phenomenon revisited: time to readmission in 17′145 [corrected] patients with 37′697 hospitalisations at a German psychiatric hospital. PLoS One. 2013;8(10):e75612.CrossRefPubMedPubMedCentral Frick U, Frick H, Langguth B, Landgrebe M, Hubner-Liebermann B, Hajak G. The revolving door phenomenon revisited: time to readmission in 17′145 [corrected] patients with 37′697 hospitalisations at a German psychiatric hospital. PLoS One. 2013;8(10):e75612.CrossRefPubMedPubMedCentral
19.
go back to reference Duhig M, Gunasekara I, Patterson S. Understanding readmission to psychiatric hospital in Australia from the service users’ perspective: a qualitative study. Health Soc Care Community. 2015; Duhig M, Gunasekara I, Patterson S. Understanding readmission to psychiatric hospital in Australia from the service users’ perspective: a qualitative study. Health Soc Care Community. 2015;
20.
go back to reference Mgutshini T. Risk factors for psychiatric re-hospitalization: an exploration. International journal of mental health nursing. 2010;19(4):257–67.CrossRefPubMed Mgutshini T. Risk factors for psychiatric re-hospitalization: an exploration. International journal of mental health nursing. 2010;19(4):257–67.CrossRefPubMed
21.
go back to reference Bench S, Day T. The user experience of critical care discharge: a meta-synthesis of qualitative research. Int J Nurs Stud. 2010;47(4):487–99.CrossRefPubMed Bench S, Day T. The user experience of critical care discharge: a meta-synthesis of qualitative research. Int J Nurs Stud. 2010;47(4):487–99.CrossRefPubMed
22.
go back to reference Killaspy H, Marston L, Green N, Harrison I, Lean M, Cook S, Mundy T, Craig T, Holloway F, Leavey G. Clinical effectiveness of a staff training intervention in mental health inpatient rehabilitation units designed to increase patients’ engagement in activities (the rehabilitation effectiveness for activities for life [REAL] study): single-blind, cluster-randomised controlled trial. The Lancet Psychiatry. 2015;2(1):38–48.CrossRefPubMed Killaspy H, Marston L, Green N, Harrison I, Lean M, Cook S, Mundy T, Craig T, Holloway F, Leavey G. Clinical effectiveness of a staff training intervention in mental health inpatient rehabilitation units designed to increase patients’ engagement in activities (the rehabilitation effectiveness for activities for life [REAL] study): single-blind, cluster-randomised controlled trial. The Lancet Psychiatry. 2015;2(1):38–48.CrossRefPubMed
23.
go back to reference Thomas K, Rickwood DJ, Bussenschutt G. Adult Step-up Step-down: A sub-acute short-term residential mental health service. International Journal of Psychosocial Rehabilitation Vol 19 (1). 2015;13:21. Thomas K, Rickwood DJ, Bussenschutt G. Adult Step-up Step-down: A sub-acute short-term residential mental health service. International Journal of Psychosocial Rehabilitation Vol 19 (1). 2015;13:21.
24.
go back to reference Thomas KA, Rickwood DJ, Brown PM. Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia. Health Soc Care Community. 2017;25(1):243–54.CrossRefPubMed Thomas KA, Rickwood DJ, Brown PM. Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia. Health Soc Care Community. 2017;25(1):243–54.CrossRefPubMed
25.
go back to reference Warner R. The roots of hospital alternative care. Br J. psychiatry Supplement. 2010;53:s4–5.CrossRef Warner R. The roots of hospital alternative care. Br J. psychiatry Supplement. 2010;53:s4–5.CrossRef
26.
go back to reference Pope C, Mays N. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ: British Med J. 1995;311(6996):42.CrossRef Pope C, Mays N. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ: British Med J. 1995;311(6996):42.CrossRef
27.
go back to reference Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40(8):795–805.CrossRefPubMed Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scand J Public Health. 2012;40(8):795–805.CrossRefPubMed
28.
go back to reference Malterud K, Siersma VD, Guassora AD: Sample size in qualitative interview studies guided by information power. Qual Health Res 2015:1049732315617444. Malterud K, Siersma VD, Guassora AD: Sample size in qualitative interview studies guided by information power. Qual Health Res 2015:1049732315617444.
29.
go back to reference Shen GC, Snowden LR. Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform. Int J Ment Heal Syst. 2014;8(1):47.CrossRef Shen GC, Snowden LR. Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform. Int J Ment Heal Syst. 2014;8(1):47.CrossRef
30.
go back to reference Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445–52.CrossRefPubMed Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445–52.CrossRefPubMed
31.
go back to reference van Wel T, Felling A, Persoon J. The effect of psychiatric rehabilitation on the activity and participation level of clients with long-term psychiatric disabilities. Community Ment Health J. 2003;39(6):535–46.CrossRefPubMed van Wel T, Felling A, Persoon J. The effect of psychiatric rehabilitation on the activity and participation level of clients with long-term psychiatric disabilities. Community Ment Health J. 2003;39(6):535–46.CrossRefPubMed
32.
go back to reference Bejerholm U, Eklund M. Time use and occupational performance among persons with schizophrenia. Occup Ther Ment Health. 2004;20(1):27–47.CrossRef Bejerholm U, Eklund M. Time use and occupational performance among persons with schizophrenia. Occup Ther Ment Health. 2004;20(1):27–47.CrossRef
33.
go back to reference Killaspy H, Marston L, Green N, Harrison I, Lean M, Holloway F, Craig T, Leavey G, Arbuthnott M, Koeser L. Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England. BMC psychiatry. 2016;16(1):1.CrossRef Killaspy H, Marston L, Green N, Harrison I, Lean M, Holloway F, Craig T, Leavey G, Arbuthnott M, Koeser L. Clinical outcomes and costs for people with complex psychosis; a naturalistic prospective cohort study of mental health rehabilitation service users in England. BMC psychiatry. 2016;16(1):1.CrossRef
34.
go back to reference Palmstierna T, Huitfeldt B, Wistedt B. The relationship of crowding and aggressive behavior on a psychiatric intensive care unit. Hosp Community Psychiatry. 1991;42(12):1237–40.PubMed Palmstierna T, Huitfeldt B, Wistedt B. The relationship of crowding and aggressive behavior on a psychiatric intensive care unit. Hosp Community Psychiatry. 1991;42(12):1237–40.PubMed
35.
go back to reference van der Schaaf PS, Dusseldorp E, Keuning FM, Janssen WA, Noorthoorn EO. Impact of the physical environment of psychiatric wards on the use of seclusion. Br J Psychiatry. 2013;202:142–9.CrossRefPubMed van der Schaaf PS, Dusseldorp E, Keuning FM, Janssen WA, Noorthoorn EO. Impact of the physical environment of psychiatric wards on the use of seclusion. Br J Psychiatry. 2013;202:142–9.CrossRefPubMed
36.
go back to reference Olver J, Love M, Daniel J, Norman T, Nicholls D. The impact of a changed environment on arousal levels of patients in a secure extended rehabilitation facility. Australas Psychiatry. 2009;17(3):207–11.CrossRefPubMed Olver J, Love M, Daniel J, Norman T, Nicholls D. The impact of a changed environment on arousal levels of patients in a secure extended rehabilitation facility. Australas Psychiatry. 2009;17(3):207–11.CrossRefPubMed
37.
go back to reference Iyendo TO, Uwajeh PC, Ikenna ES. The therapeutic impacts of environmental design interventions on wellness in clinical settings: a narrative review. Complement Ther Clin Pract. 2016;24:174–88.CrossRefPubMed Iyendo TO, Uwajeh PC, Ikenna ES. The therapeutic impacts of environmental design interventions on wellness in clinical settings: a narrative review. Complement Ther Clin Pract. 2016;24:174–88.CrossRefPubMed
38.
go back to reference Taylor TL, Killaspy H, Wright C, Turton P, White S, Kallert TW, Schuster M, Cervilla JA, Brangier P, Raboch J, et al. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems. BMC psychiatry. 2009;9:55.CrossRefPubMedPubMedCentral Taylor TL, Killaspy H, Wright C, Turton P, White S, Kallert TW, Schuster M, Cervilla JA, Brangier P, Raboch J, et al. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems. BMC psychiatry. 2009;9:55.CrossRefPubMedPubMedCentral
39.
go back to reference Hesselink G, Flink M, Olsson M, Barach P, Dudzik-Urbaniak E, Orrego C, Toccafondi G, Kalkman C, Johnson JK, Schoonhoven L. Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ quality & safety. 2012;21(Suppl 1):i39–49.CrossRef Hesselink G, Flink M, Olsson M, Barach P, Dudzik-Urbaniak E, Orrego C, Toccafondi G, Kalkman C, Johnson JK, Schoonhoven L. Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ quality & safety. 2012;21(Suppl 1):i39–49.CrossRef
40.
go back to reference Crawford M, Ed J, Freeman G, Weaver T. Providing continuity of care for people with severe mental illness. Soc Psychiatry Psychiatr Epidemiol. 2004;39(4):265–72.CrossRefPubMed Crawford M, Ed J, Freeman G, Weaver T. Providing continuity of care for people with severe mental illness. Soc Psychiatry Psychiatr Epidemiol. 2004;39(4):265–72.CrossRefPubMed
41.
go back to reference Hautala-Jylha PL, Nikkonen M, Jylha J. Conceptions of patients and personnel concerning the substance of post-ward outpatient visits in psychiatric care. J Psychiatr Ment Health Nurs. 2006;13(1):61–9.CrossRefPubMed Hautala-Jylha PL, Nikkonen M, Jylha J. Conceptions of patients and personnel concerning the substance of post-ward outpatient visits in psychiatric care. J Psychiatr Ment Health Nurs. 2006;13(1):61–9.CrossRefPubMed
42.
go back to reference Brown H, Brown H, Howlett F, Howlett F. A critical evaluation of the “short stay project”–service users’ perspectives. Housing, Care and Support. 2017;20(2):71–84.CrossRef Brown H, Brown H, Howlett F, Howlett F. A critical evaluation of the “short stay project”–service users’ perspectives. Housing, Care and Support. 2017;20(2):71–84.CrossRef
43.
go back to reference Noseworthy AM, Sevigny E, Laizner AM, Houle C, La Riccia P. Mental health care professionals’ experiences with the discharge planning process and transitioning patients attending outpatient clinics into community care. Arch Psychiatr Nurs. 2014;28(4):263–71.CrossRefPubMed Noseworthy AM, Sevigny E, Laizner AM, Houle C, La Riccia P. Mental health care professionals’ experiences with the discharge planning process and transitioning patients attending outpatient clinics into community care. Arch Psychiatr Nurs. 2014;28(4):263–71.CrossRefPubMed
44.
go back to reference Wright N, Rowley E, Chopra A, Gregoriou K, Waring J. From admission to discharge in mental health services: a qualitative analysis of service user involvement. Health Expect. 2016;19(2):367–76.CrossRefPubMed Wright N, Rowley E, Chopra A, Gregoriou K, Waring J. From admission to discharge in mental health services: a qualitative analysis of service user involvement. Health Expect. 2016;19(2):367–76.CrossRefPubMed
Metadata
Title
Like a hotel, but boring: users’ experience with short-time community-based residential aftercare
Authors
Eirik Roos
Ottar Bjerkeset
Margrét Hrönn Svavarsdóttir
Aslak Steinsbekk
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2777-z

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