‘I don't want to be here but I feel safe’: Referral and admission to a child and adolescent psychiatric inpatient unit: The young person's perspective

Abstract

Early and appropriate intervention can assist children and young people manage their mental illness and prevent it becoming a long-term condition. However, satisfaction with mental health services can influence the level of engagement individuals are willing to participate in beyond the time of the initial contact or hospitalization. A qualitative design was used to identify and understand the experiences of the admission process for young people referred to the sole psychiatric inpatient unit in one Australian state for children up to the age of 18 years. Eleven young people participated in semistructured interviews that were audiotaped, transcribed, and coded. Interview data were examined through thematic analysis. Satisfaction with the inpatient experience was influenced by whether or not young people experienced a sense of connection with staff or other patients on the ward. The ability of nursing staff in identifying and catering to the individual needs of young people in their care facilitated feelings of safety, security, and acceptance, and contributed to the young person's desire to remain engaged in treatment post-discharge. This research supports the shift towards perceiving patient satisfaction as a separate entity from service delivery and quality, with some participants able to voice dissatisfaction about the lack of services, while reporting overall satisfaction with the inpatient experience.

Participation of youth in decision‐making procedures during residential care: A narrative review

“…Challenges and facilitators related to the young person's care trajectory and treatment are shown in four studies and refer to the number of prior placements (Southwell & Fraser, 2010) and the stages of the care path (Carrà, 2014;Hepper et al, 2005;Salamone-Violi et al, 2015). With regard to prior placements, young people who experienced less than four alternative placements prior to their stay in residential care reported more often that their caregivers (professionals) listened to them compared with their peers reporting more than four placements (Southwell & Fraser, 2010).…”

“…The 10 studies focusing on the organization/service show challenges and facilitators with regard to the aspect of time (Pålsson, 2015;Salamone-Violi et al, 2015;Stevens, 2008), the organizational culture (study Brown et al, 2010;Brown et al, 2011;Henriksen et al, 2008), and the policy context (Brown et al, 2011;Cousins & Milner, 2006;Fudge Schormans & Rooke, 2008;Manful & Manful, 2013). For instance, the study by Brown et al (2011) shows that facilities that agreed licensing and accreditation should require family and youth involvement and were more likely to be either licensed or accredited than facilities that disagreed.…”

“…Most studies report on the role of the professional in promoting or obstructing the young person's participation process (Brown et al, 2011;Fudge Schormans & Rooke, 2008;Hitzler & Messmer, 2010;Manful & Manful, 2013;Pålsson, 2015;Roesch-March, 2014). respect, and reciprocity is regarded as a key aspect in promoting the young person's participation (Brown et al, 2011;Cousins & Milner, 2006;Henriksen et al, 2008;Malmsten, 2014;Salamone-Violi et al, 2015;Stevens, 2008). respect, and reciprocity is regarded as a key aspect in promoting the young person's participation (Brown et al, 2011;Cousins & Milner, 2006;Henriksen et al, 2008;Malmsten, 2014;Salamone-Violi et al, 2015;Stevens, 2008).…”

Nursing in child psychiatric milieus: What nurses do: An update

“…But providing support also demands that staff interact such that they forge engagement and connect with the child (Polacek et al., ). Engagement that operates at the interpersonal level involves empathy but also aims at attunement with the child's experience and, for adolescents, to understand what is meaningful to them as they navigate hospitalization (Salamone‐Violi, Chur‐Hansen, & Winefield, ). As stated in the original article,

Children experience support when they sense staff's genuine interest in their ideas, attitudes and perceptions.

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“…Nurses understand that while adolescents may feel a sense of safety on the unit, there is also a sense of being in a “fake world” that does not present the authentic challenges they must face once discharged (Gill, Butler, & Pistrang, ). When interviewed about the hospitalization experience, particulary being cut off from the flow of their customary patterns, adolescents stress the importance of a connection with staff members who take a genuine interest in their life and experiences (Salamone‐Violi et al., ; Ward, 2014a). As with adults, nurses attempt to connect by bringing interactions to the interpersonal level; directing attention to establishing presence, an empathic bridge, and tailoring responses based on a sense of the adolescent's experience (Delaney, Shattell, & Johnson, ).…”