Understanding consumers’ initial expectations of community‐based residential mental health rehabilitation in the context of past experiences of care: A mixed‐methods pragmatic grounded theory analysis

Abstract

This study explores how consumers expect community-based residential mental health rehabilitation to compare with previous experiences of care. Understanding what consumers hope to receive from mental health services, and listening to their perspectives about what has and has not worked in previous care settings, may illuminate pathways to improved service engagement and outcomes. A mixed-methods research design taking a pragmatic approach to grounded theory guided the analysis of 24 semi-structured interviews with consumers on commencement at three Community Care Units (CCUs) in Australia. Two of these CCUs were trialling a staffing model integrating peer support work with clinical care. All interviews were conducted by an independent interviewer within the first 6 weeks of the consumer's stay. All participants expected the CCU to offer an improvement on previous experiences of care. Comparisons were made to acute and subacute inpatient settings, supported accommodation, and outpatient care. Consumers expected differences in the people (staff and co-residents), the focus of care, physical environ, and rules and regulations. Participants from the integrated staffing model sites articulated the expected value of a less clinical approach to care. Overall, consumers' expectations aligned with the principles articulated in policy frameworks for recovery-oriented practice. However, their reflections on past care suggest that these services continue to face significant challenges realizing these principles in practice. Paying attention to the kind of working relationship consumers want to have with mental health services, such as the provision of choice and maintaining a practical and therapeutic supportive focus, could improve their engagement and outcomes.

A systematic review of service models and evidence relating to the clinically operated community-based residential mental health rehabilitation for adults with severe and persisting mental illness in Australia

“… a [23, 42, 43], b [15, 24–28, 44], c [1, 16, 24, 30, 39, 40, 45], d [33], e [31, 46, 47], f [10, 29, 48], g [32]…”

Consumers' understanding and expectations of a community-based recovery-oriented mental health rehabilitation unit: a pragmatic grounded theory analysis

“…The interview schedule was framed by three topics about the CCU: how participants came to be there; expectations of the experience; and expectations of how this would compare to previous mental health care experiences. This paper presents an analysis of the first two topics; the third is the subject of a separate paper (Parker et al 2017). Interviews were completed between December 2014 and January 2016 by an independent research assistant (EN).…”

Recovery services and expectation of consumers and mental health professionals in community-based residential facilities of Ghana

“…Given this, MHPs should be given in-service training to improve their knowledge regarding recovery and how to handle aggressive consumers. This is because consumer related challenges can negatively impact on personal recovery process [1,12,44].…”

“…In recent times, assessment of consumers' and MHPs expectation regarding mental health services is considered relevant in building partnership between these stakeholders and in developing their shared goals [16,17,44]. For example, listening to consumers' expectations, and what they hope to achieve, helps to examine their priorities and preferences [17,44]. Thus, empirical evidence is needed to explore consumers' and MHPs' expectation concerning recovery services.…”

“…Despite this, research evidence on such expectations of consumers and MHPs is limited. The few evidence regarding consumers' and MHPs' perspectives on recovery and expectation are conducted in developed countries, such as Australia, UK and US [16,17,44].…”