“I Hope I Can Make it Out There”: Perceptions of Women with Severe Mental Illness on the Transition from Hospital to Community

Abstract

This study explores the experience of women with severe mental illness in transition from psychiatric hospital care to the community. Three focus groups were conducted among women with severe mental illness from transitional residences at two state psychiatric hospitals. Focus group transcripts and notes were coded according to women's perceived challenges and facilitators of transition. Participants described several challenges including fear of insufficient treatment support, safety concerns, social isolation, stigma, and lack of resources to meet daily needs. The supports that women described as important were an orientation to the neighborhood and residence, access to treatment support with flexibility, and connection to social supports.

"I Want to Go Home, but I Need to Stay": The Transition to become Ready for Discharge from Acute Psychiatric Wards, as Narrated by Persons Who Experienced Acute Psychotic Illness

“…When nurses initiated the plan to discharge participants from acute psychiatric wards, the participants expressed both their wish to go home and their need to stay on the ward because they needed to feel better before leaving. These results correspond with those of previous studies reporting that persons want to adjust the timing of discharge based on their experience of the illness, care needs and social needs related to their personal circumstances [18,19,21]. In addition, our results show that the participants' awareness of the transition was related to their experience of the changes in their acute psychotic illness and insight about their need of mental health nursing care on the ward before the discharge.…”

“…Other researchers have described that some persons with severe mental illness report care needs that are too serious and complex for community mental health nurses to sufficiently meet them [19,22]. Furthermore, Manuel et al [21] described persons' predischarge worries about community mental health nurses' availability and ability to meet their safety, security and social support needs. Our results show that participants know that they need to feel better before discharge as a fundament to cope with daily life at home.…”

“…[28,47]). Other authors have also reported that persons with severe mental illness express feeling unsafe and insecure before discharge about if the community mental health care can meet their care needs [9,[20][21][22]. Community mental health service that is provided by appointments primarily at daytime seems at this period of time after the acute psychotic illness not to be sufficient to the participants' needs of safety to manage their daily life at home.…”

“…Persons wished that nurses better prepared them for discharge by introducing them to peers who had experienced discharges from acute psychiatric wards so that they could receive more information about health problems that may occur, medication treatment and the prevention of mental illness relapses [20]. Manuel et al [21] explored the discharge experiences of women with severe mental illness after a long-term stay in psychiatric institutions and reported that these women were concerned that the community mental health care would be insufficient to meet their needs of safety, security and support in entering social relationships with other people. Gerson and Rose [22] reported similar results, and found that persons with severe mental illness were unsure whether community mental health nurses care could meet their illness-related needs and needs of support in daily activities.…”

Locating community among people with schizophrenia living in a diverse urban environment

“…For example, while younger and older adults both experience a strong link between quality of life and community participation, Kaplan and colleagues (2012) found emphases among youth on educational involvement and friends, while for mature adults emphases were upon parenting, spirituality, and peer-support. Another study indicated that while women struggled to a lesser extent with social inclusion, themes of safety of living environment were more pivotal (Manuel, Hinterland, Conover & Herman, 2012).…”