Life in acute mental health settings: experiences and perceptions of service users and nurses

Abstract

Background. Acute psychiatric provision in the UK today as well as globally has many critics including service users and nurses. Method. Four focus groups, each meeting twice, were held separately for service users and nurses. The analysis was not purely inductive but driven by concerns with the social position of marginalised groups - both patients and staff. Results. The main themes were nurse/patient interaction and coercion. Service users and nurses conceptualised these differently. Service users found nurses inaccessible and uncaring, whereas nurses also felt powerless because their working life was dominated by administration. Nurses saw coercive situations as a reasonable response to factors 'internal' to the patient whereas for service users they were driven to extreme behaviour by the environment of the ward and coercive interventions were unnecessary and heavy handed. Conclusion. This study sheds new light on living and working in acute mental health settings today by comparing the perceptions of service users and nurses and deploying service user and nurse researchers. The intention is to promote better practice by providing a window on the perceptions of both groups.

A systematic review of factors associated with service user satisfaction with psychiatric inpatient services

“…Two found that higher levels of experienced coercion were related to lower overall satisfaction (Middelboe et al, 2001;Smith et al, 2014). Qualitative interviews in one study (Rose et al, 2015) describe a pattern of coercion occurring as a result of service users frustrations with the limitations of the ward environment. Further qualitative research has also found that service users perceive satisfaction as being influenced by the fear of violence (Duggins and Shaw, 2006).…”

“…They also did not score highly regarding representativeness of the sample, mainly due to a failure to report the number of people who had declined to participate, and the associated reasons. Of the qualitative studies, one scored 25% (Duggins and Shaw, 2006) and three scored 50% (Rose et al, 2015;Stewart et al, 2015;Wallace et al, 1999). The qualitative papers generally scored well for reporting the analysis used, but there was little or no acknowledgement of the impact of the researcher on the research process.…”

“…Five studies considered the impact of a locked environment on service user satisfaction (Kuosmanen et al, 2006;Middelboe et al, 2001;Muller et al, 2002;Olusina et al, 2002;Rose et al, 2015). Three (Kuosmanen et al, 2006;Muller et al, 2002;Rose et al, 2015), reported that satisfaction was higher on open wards, when less restrictions were placed on free movement.…”

“…Three (Kuosmanen et al, 2006;Muller et al, 2002;Rose et al, 2015), reported that satisfaction was higher on open wards, when less restrictions were placed on free movement. Olusina et al (2002) reported that dissatisfaction was associated with the curtailment of freedom, which would likely be experienced on a closed ward environment.…”

‘Give us something to do’: reflections on running a group therapy programme

“…At the same time, there is intense pressure to discharge patients as quickly as possible to free up beds as inpatient care becomes more and more of a scarce and expensive resource. The majority of nursing time may therefore be spent on responding to crisis and risk management, and on tasks such as paperwork and bed managements which do not involve direct patient contact (Mullen 2009;Rose et al, 2015).…”