‘Going into the unknown’: Experiences of male patients in secure settings during environmental transition

Abstract

Little is known about the experiences of male patients in secure mental health and intellectual disability units during environmental transition. We interviewed patients before (n = 9) and after (n = 8) a side-to-side security transition from medium-secure wards in an older building to new wards in a purpose-built building. We inquired about transitional experiences in general and about this transition specifically. We examined interview transcripts and field notes using thematic analysis, and collated routine outcome data to gauge whether transition had obvious positive or negative effects. Qualitative analysis indicated three major themes (information, transition, and behaviour) and five overlapping subthemes (positive information sharing and consultation, concerns and anxieties about lack of information, life change and opportunity, home and sense of belonging, and potential conflict). Outcome data indicated little obvious change between first and second interviews. Expressed concerns of patients about transition were largely about tangible and practical issues, including changes to rules, including smoking and prohibited items. The results highlight the need for the development of supportive patient-inclusion strategies, consistent and transparent communication processes, and a published timeframe during the planning and implementation phases of all types of transitional moves, including the side-to-side transfer of residents between accommodation buildings.

Adverse mental health inpatient experiences: Qualitative systematic review of international literature and development of a conceptual framework

“…53, 62, 70 Participants reported a lack of information-sharing by staff. 16, 18, 25, 26, 33, 46, 55, 61, 62, 68, 71–74 Lack of involvement in decision-making processes was viewed as highly distressing, impacting personal autonomy and inherently limiting the therapeutic nature of inpatient care. 18, 19, 24, 27, 30, 33, 36, 46, 49, 57, 68, 71, 75–77 Extrapolating from this, adverse experience emerged from an incongruence between the expectations or beliefs of the staff and those of patients, 32, 36, 50, 78–82 a phenomenon described as a battle of expectation versus disappointment.…”

“…Participants felt unprepared for transfer due to a lack of clear communication about the process. 15, 18, 57, 74, 98, 116, 120 Decisions about transfer were viewed as processes that happen to rather than with patients. 18, 98, 116, 120 This could lead to a heightened sense of loss of control.…”

“…Feelings of restricted choice due to involuntary admission and forced treatment were regularly linked to a perceived loss of autonomy. 24, 25, 27, 43, 57, 59, 68, 73, 74, 76, 90, 95 However, of apparent greater concern was the issue of false choices. 73, 116 A pertinent example concerned voluntary patients who frequently reported that, despite the non-enforced status of their admission, they were given the choice of being admitted to or remaining in hospital voluntarily or being detained under mental health legislation.…”

Recovery‐focussed care: How it can be utilized to reduce aggression in the acute mental health setting

“…Previous negative experiences of hospitalization might make the consumer relive these unpleasant memories and display heightened emotions, high levels of anxiety, or become easily frustrated (Parkes et al . ; Russinova et al . ).…”

Exploration of “Talking Groups” within a medium secure setting

“…Findings revealed that gaining information about low secure services was of value to those patients who were close to moving on to a low secure hospital. Parkes et al (2015) examined transition experiences of patients in a medium secure setting before and after their transition to a new ward and found that patients were unhappy about the lack of information provided before their move and experienced stress and anxiety about “fitting in” and meeting new people. Continuing to offer information sessions to patients as part of the talking groups may alleviate concerns around transitioning to a new ward.…”