Inpatient care 50 years after the process of deinstitutionalisation

Abstract

PurposeThroughout 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.MethodsEight 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.ResultsLess 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.ConclusionsService 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.

Exploring the relationship between activities and emotional experience using a diary in a mental health inpatient setting

“…Engagement in inpatient activity has also been found to be associated with perceived quality of inpatient care (Csipke et al . ).…”

“…) and few organized care activities (Csipke et al . ; Radcliffe & Smith ). Comparable studies from the past five decades have indicated that inpatient milieus are becoming increasing less engaging over time (Csipke et al .…”

“…Comparable studies from the past five decades have indicated that inpatient milieus are becoming increasing less engaging over time (Csipke et al . ; Curson et al . ; Wing & Brown ).…”

“…Even though at least one comparable study suggested a continued decline in meaningful activity within psychiatric hospitals (Csipke et al . ), current hospital milieus and activities have been explored less frequently, and this merits a renewed investigation. Activity studies to date often have also employed observer‐rated rather than patient‐rated assessments (Sharac et al .…”

The therapeutic role of mental health nurses in psychiatric intensive care: A mixed‐methods investigation in an inner‐city mental health service

“…Low staffing levels, administrative demands and restrictive measures to maintain safety (Csipke et al., ; Thomson & Hamilton, ) are cited as barriers to therapeutic engagement. With bed numbers declining, only the most acutely unwell people are admitted to inpatient units (Royal College of Psychiatrists, ).…”