Perceptions of involuntary admission and risk of subsequent readmission at one-year follow-up: The influence of insight and recovery style

O’Donoghue, Brian; Lyne, John; Hill, Michele; O'Rourke, Linda; Daly, Sally; Larkin, Conall; Feeney, Larkin; O’Callaghan, Eadbhard

doi:10.3109/09638237.2011.562263

Cited by 30 publications

(29 citation statements)

References 21 publications

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“…In around half of the papers the analysis considered readmission to all possible hospitals. In three cases, readmission was restricted to involuntary readmission in the context of involuntary index admission or detention [14, 41, 42] while in other three [33, 34, 43] involuntary readmitted patients were explicitly excluded from the analysis. In one paper readmission specific for self-harm was considered [44].…”

Section: Resultsmentioning

confidence: 99%

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

et al. 2016

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BackgroundReadmission rate is considered an indicator of the mental health care quality. Previous studies have examined a number of factors that are likely to influence readmission. The main objective of this systematic review is to identify the studied pre-discharge variables and describe their relevance to readmission among psychiatric patients.MethodsStudies on the association between pre-discharge variables and readmission after discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey. Relevant publications published between January 1990 and June 2014 were included. For each variable, the number of papers that considered it as a predictor of readmission and that found a significant association was recorded, together with the association direction and whether it was found respectively in bivariate and in multivariate analyses.ResultsOf the 734 articles identified in the search, 58 papers were included in this review, mainly from the USA and concerning patients with severe mental disorders. Analysed variables were classified according to the following categories: patients’ demographic, social and economic characteristics; patients’ clinical characteristics; patients’ clinical history; patients’ attitude and perception; environmental, social and hospital characteristics; and admission and discharge characteristics. The most consistently significant predictor of readmission was previous hospitalisations. Many socio-demographic variables resulted as influencing readmission, but the results were not always homogeneous. Among other patients’ clinical characteristics, diagnosis and measures of functional status were the most often used variables. Among admission characteristics, length of stay was the main factor studied; however, the results were not very consistent. Other relevant aspects resulted associated with readmission, including the presence of social support, but they have been considered only in few papers. Results of quality assessment are also reported in the review. The majority of papers were not representative of the general psychiatric population discharged from an inpatient service. Almost all studies used multivariate analytical methods, i.e., confounders were controlled for, but only around 60% adjusted for previous hospitalisation, the variable most consistently considered associated to readmission in the literature.ConclusionsThe results contribute to increase knowledge on pre-discharge factors that could be considered by researchers as well as by clinicians to predict and prevent readmissions of psychiatric patients. Associations are not always straightforward and interactions between factors have to be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1114-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

et al. 2016

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“…For example, a large proportion of the participants had more than one admission (65.2%) and were assigned a diagnosis of non-affective psychotic disorder (69.6%); both of which have been reported to inform persistently negative attitudes towards involuntary admission and care O'Donoghue et al 2010O'Donoghue et al , 2011aO'Donoghue et al , 2011bO'Donoghue et al , 2016Priebe et al 2010;Smith et al 2014). Previous evidence also suggests that service users who are subject to coercive measures tend to hold negative attitudes about the care they received O'Donoghue et al 2010O'Donoghue et al , 2011aO'Donoghue et al , 2011bO'Donoghue et al , 2016Priebe et al 2010;Smith et al 2014). Participants in this study also reported feeling coerced in other aspects of their admission, described elsewhere (Murphy et al in press), and this may have impacted on their appraisals of the MHT.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly significant as only two of the service users involved in our study had their admission order revoked by the tribunal. To date, research investigating the factors influencing service users' attitudes towards the MHT process is sparse, hence future research is needed to identify the relevant demographic and clinical variables, such as those found to influence service users' attitudes towards involuntary admission in other studies O'Donoghue et al 2010O'Donoghue et al , 2011aO'Donoghue et al , 2011bO'Donoghue et al , 2016Priebe et al 2010;Smith et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Service users’ experiences of mental health tribunals in Ireland: a qualitative analysis

Murphy

McGuinness

Bainbridge

et al. 2017

Ir. j. psychol. Med.

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Objectives. To explore the mental health tribunal experiences of people admitted involuntarily under the Mental Health Act 2001.Methods. Employing a qualitative descriptive study design, data were collected from 23 service users who had experienced mental health tribunals during a recent involuntary admission. Face-to-face semi-structured interviews were conducted 3 months post-revocation of their involuntary admission order. Data were analysed using an inductive thematic process.Results. The majority of participants reported mixed experiences comprising positive and negative aspects in relation to information provision, emotional support and an inclusive atmosphere. Some participants reported receiving accessible information about the tribunal process, felt emotionally supported throughout, and encountered respectful and dignifying practices during the tribunal proceedings. However, many participants described experiencing non-inclusive practices, reported feeling ill-informed regarding the tribunal process, emotionally unsupported during and after the tribunal, and distressed by what they perceived as adversarial tribunal proceedings.Conclusions. Systemic changes could ensure that the positive experiences encountered by the minority of participants in this study are more consistently experienced. Ongoing education and training of stakeholders in the provision of inclusive tribunal practices, and the provision of accessible information and emotional support to service users through the stages of the involuntary admission process appear likely to be beneficial. Service users should automatically be offered the option of having a support person of their choosing present during tribunals.

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“…The study found that before discharge, 72% of service users perceived that their involuntary admission had been necessary (O'Donoghue et al 2010) and this reduced to 60% after 1 year (O'Donoghue et al 2011b). In the year following discharge, nearly two-thirds of service users engaged with their treating team and 43% were readmitted within 1 year, half of which, were involuntary (O'Donoghue et al 2011b). A large study had been conducted in the United Kingdom at a similar time and this found that only 40% of individuals admitted involuntarily perceived that their admission was justified (Priebe et al 2009).…”

Section: Introductionmentioning

confidence: 93%

Service users’ perspective of their admission: a report of study findings

O’Donoghue

Roche²,

Lyne

et al. 2016

Ir. j. psychol. Med.

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Objectives. The 'Service Users' Perspective of their Admission' study examined voluntarily and involuntarily admitted services users' perception of coercion during the admission process and whether this was associated with factors such as the therapeutic alliance, satisfaction with services, functioning and quality of life. This report aims to collate the findings of the study.Methods. The study was undertaken across three community mental health services in Ireland. Participants were interviewed before discharge and at 1 year using the MacArthur Admission Experience. Caregivers of participants were interviewed about their perception of coercion during the admission.Results. A total of 161 service users were interviewed and of those admitted involuntarily, 42% experienced at least one form of physical coercion. Service users admitted involuntarily reported higher levels of perceived coercion and less procedural justice than those admitted voluntarily. A total of 22% of voluntarily admitted service users reported levels of perceived coercion comparable with involuntarily admitted service users and this was associated with treatment in a secure ward or being brought to hospital initially under mental health legislation. In comparison with the service user, caregivers tended to underestimate the level of perceived coercion. The level of procedural justice was moderately associated with the therapeutic relationship and satisfaction with services. After 1 year, 70% experienced an improvement in functioning and this was not associated with the accumulated level of coercive events, when controlled for confounders.Conclusions. This study has provided valuable insights into the perceptions of coercion and can help inform future interventional studies aimed at reducing coercion in mental health services.

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Perceptions of involuntary admission and risk of subsequent readmission at one-year follow-up: The influence of insight and recovery style

Abstract: Peoples' perception of the necessity of their involuntary admissions is not stable over time and risk of involuntary readmission is associated with recovery style.

Cited by 30 publications

References 21 publications

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

Pre-discharge factors predicting readmissions of psychiatric patients: a systematic review of the literature

Service users’ experiences of mental health tribunals in Ireland: a qualitative analysis

Service users’ perspective of their admission: a report of study findings

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