Experiences of delivering and receiving mental healthcare in the acute hospital setting: a qualitative study.
Experiences of care
Liaison psychiatry
Mental health liaison services
Qualitative
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
12 Feb 2024
12 Feb 2024
Historique:
received:
24
08
2023
accepted:
30
01
2024
medline:
13
2
2024
pubmed:
13
2
2024
entrez:
12
2
2024
Statut:
epublish
Résumé
Recent investment in UK liaison psychiatry services has focused on expanding provision for acute and emergency referrals. Little is known about the experiences of users and providers of these services. The aim of this study was to explore the experiences of users of acute liaison mental health services (LMHS) and those of NHS staff working within LMHS or referring to LMHS. A secondary aim was to explore the potential impact of a one-hour service access target on service delivery. Cross-sectional qualitative study. Individual interviews were audio-recorded, transcribed verbatim and interpreted using framework analysis. Service users reported mixed experiences of LMHS, with some reporting positive experiences and some reporting poor care. Most service users described the emergency department (ED) environment as extremely stressful and wished to be seen as quickly as possible. Staff described positive benefits of the one-hour access target but identified unintended consequences and trade-offs that affected other parts of the liaison service. The assessment and treatment of people who attend ED with mental health problems needs to improve and particular attention should be given to the stressful nature of the ED environment for those who are extremely agitated or distressed.
Sections du résumé
BACKGROUND
BACKGROUND
Recent investment in UK liaison psychiatry services has focused on expanding provision for acute and emergency referrals. Little is known about the experiences of users and providers of these services. The aim of this study was to explore the experiences of users of acute liaison mental health services (LMHS) and those of NHS staff working within LMHS or referring to LMHS. A secondary aim was to explore the potential impact of a one-hour service access target on service delivery.
METHODS
METHODS
Cross-sectional qualitative study. Individual interviews were audio-recorded, transcribed verbatim and interpreted using framework analysis.
RESULTS
RESULTS
Service users reported mixed experiences of LMHS, with some reporting positive experiences and some reporting poor care. Most service users described the emergency department (ED) environment as extremely stressful and wished to be seen as quickly as possible. Staff described positive benefits of the one-hour access target but identified unintended consequences and trade-offs that affected other parts of the liaison service.
CONCLUSIONS
CONCLUSIONS
The assessment and treatment of people who attend ED with mental health problems needs to improve and particular attention should be given to the stressful nature of the ED environment for those who are extremely agitated or distressed.
Identifiants
pubmed: 38347562
doi: 10.1186/s12913-024-10662-4
pii: 10.1186/s12913-024-10662-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
191Subventions
Organisme : National Institute for Health and Care Research
ID : 13/58/08
Organisme : National Institute for Health and Care Research
ID : 13/58/08
Organisme : National Institute for Health and Care Research
ID : 13/58/08
Organisme : National Institute for Health and Care Research
ID : 13/58/08
Organisme : National Institute for Health and Care Research
ID : 13/58/08
Organisme : National Institute for Health and Care Research
ID : 13/58/08
Informations de copyright
© 2024. Crown.
Références
The King’s Fund. What’s going on with A&E waiting times? https://www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters(2022) . Accessed 10 Aug 2023.
Cann J, Barter R, Battle J, Schwenck J, Anakwe R. Patients presenting to an acute general hospital with acute mental health needs: a retrospective observational cohort study. BMJ Open. 2022;12(3):e059102.
doi: 10.1136/bmjopen-2021-059102
pubmed: 35354634
pmcid: 8969002
Guthrie E, Romeu D, Czoski-Murray C, Relton S, Walker A, Trigwell P, Hewison J, West R, Fossey M, Hulme C, House A. Experiences of people seen in an acute hospital setting by a liaison mental health service: responses from an online survey. BMC Health Serv Res. 2021;21(1):1–2.
doi: 10.1186/s12913-021-06974-4
Eales S. Service users’ experiences of Liaison Mental Health Care (Doctoral dissertation, City University London). 2013.
Eales S, Callaghan P, Johnson B. Service users and other stakeholders’ evaluation of a liaison mental health service in an accident and emergency department and a general hospital setting. J Psychiatr Ment Health Nurs. 2006;13(1):70–7.
doi: 10.1111/j.1365-2850.2006.00915.x
pubmed: 16441396
Wand T, White K, Patching J, Dixon J, Green T. An emergency department-based mental health nurse practitioner outpatient service: part 1, participant evaluation. Int J Ment Health Nurs. 2011;20(6):392–400.
doi: 10.1111/j.1447-0349.2011.00744.x
pubmed: 21457179
Wand AP, Wood R, Fossey MJ, Aitken P. Standards, efficiency and effectiveness in consultation-liaison psychiatry. Aust NZJ Psychiatry. 2015;49(2):104–5.
doi: 10.1177/0004867414563580
Summers M, Happell B. Patient satisfaction with psychiatric services provided by a Melbourne tertiary hospital emergency department. J Psychiatr Ment Health Nurs. 2003;10(3):351–7.
doi: 10.1046/j.1365-2850.2003.00600.x
pubmed: 12755921
NHS England. NHS England proposes new mental health access standards. 2021. https://www.england.nhs.uk/2021/07/nhs-england-proposes-new-mental-health-access-standards/ . Accessed 10 Aug 2023.
NHS England. Next steps on the NHS five year forward view. https://www.england.nhs.uk/wp-content/uploads/2017/03/NEXT-STEPS-ON-THE-NHS-FIVE-YEAR-FORWARD-VIEW.pdf . Accessed 10 Aug 2023.
NHS England. Achieving better access to 24/7 urgent and emergency mental health care. 2016. https://www.england.nhs.uk/wp-content/uploads/2016/11/lmhs-guidance.pdf . Accessed 10 Aug 2023.
Keeble J, Walker A, Guthrie E, Trigwell P, Quirk A, Hewison J, Murray CC, House A. Integrated liaison psychiatry services in England: a qualitative study of the views of liaison practitioners and acute hospital staffs from four distinctly different kinds of liaison service. BMC Health Serv Res. 2019;19(1):1–4.
House A, Guthrie E, Walker A, Hewsion J, Trigwell P, Brennan C, Crawford M, Murray CC, Fossey M, Hulme C, Martin A. A programme theory for liaison mental health services in England. BMC Health Serv Res. 2018;18:1–1.
doi: 10.1186/s12913-018-3539-2
NIHR. Liaison Psychiatry: Measurement And Evaluation of Service Types, Referral patterns and Outcomes LP-MAESTRO. (2015) https://fundingawards.nihr.ac.uk/award/13/58/08#/ (2015) . Accessed 10 Aug 2023.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.
doi: 10.1093/intqhc/mzm042
pubmed: 17872937
Srivastava A, Thomson SB. Framework analysis: a qualitative methodology for applied policy research. 2009. JOAAG. 2022;4(2):72–9.
Wand T, White K, Patching J. Realistic evaluation of an emergency department-based mental health nurse practitioner outpatient service in Australia. Nurs Health Sci. 2011;13(2):199–206.
doi: 10.1111/j.1442-2018.2011.00601.x
pubmed: 21595814
Wand T, White K, Patching J, Dixon J, Green T. Outcomes from the evaluation of an emergency department-based mental health nurse practitioner outpatient service in Australia. J Am Acad Nurse Pract. 2012;24(3):149–59.
doi: 10.1111/j.1745-7599.2011.00709.x
pubmed: 22404793
Wand T, D’Abrew N, Barnett C, Acret L, White K. Evaluation of a nurse practitioner-led extended hours mental health liaison nurse service based in the emergency department. Aust Health Rev. 2014;39(1):1–8.
doi: 10.1071/AH14100
Schmidt M, Uman T. Experiences of acute care by persons with mental health problems: an integrative literature review. J Psychiatr Ment Health Nurs. 2020;27(6):789–806.
doi: 10.1111/jpm.12624
pubmed: 32083776
Swires-Hennessy K, Hayhurst C. Mental Health in Emergency departments: a toolkit for improving care. Online: The Royal College of Emergency Medicine; 2017.
Royal College of Psychiatrists. Hidden waits force more than three quarters of mental health patients to seek help from emergency services. 2022. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2022/10/10/hidden-waits-force-more-than-three-quarters-of-mental-health-patients-to-seek-help-from-emergency-services . Accessed 10 Aug 2023.
Thornicroft G, Sunkel C, Aliev AA, Baker S, Brohan E, El Chammay R, Davies K, Demissie M, Duncan J, Fekadu W, Gronholm PC. The Lancet Commission on ending stigma and discrimination in mental health. Lancet. 2022;400(10361):1438–80.
doi: 10.1016/S0140-6736(22)01470-2
pubmed: 36223799
Clarke D, Usick R, Sanderson A, Giles-Smith L, Baker J. Emergency department staff attitudes towards mental health consumers: a literature review and thematic content analysis. Int J Ment Health Nurs. 2014;23(3):273–84.
doi: 10.1111/inm.12040
pubmed: 23980913
Tyerman J, Patovirta AL, Celestini A. How stigma and discrimination influences nursing care of persons diagnosed with mental illness: a systematic review. Issues Ment Health Nurs. 2021;42(2):153–63.
doi: 10.1080/01612840.2020.1789788
pubmed: 32762576
NHS England. Mental health and A&E pressures. 2018. https://www.england.nhs.uk/south-east/wp-content/uploads/sites/45/2018/11/Mental-health-and-ED-pressures-case-studies-of-schemes.pdf . Accessed 10 Aug 2023.
Na JJ, Park JL, LKhagva T, Mikami AY. The efficacy of interventions on cognitive, behavioral, and affective public stigma around mental illness: a systematic meta-analytic review. Stigma Health. 2022;7(2):127.
doi: 10.1037/sah0000372
Gonzalez M, Clarke DE, Pereira A, Boyce-Gaudreau K, Waldman C, Demczuk L, Legare C. The impact of educational interventions on attitudes of emergency department staff towards patients with substance-related presentations: a quantitative systematic review. JBI Evid Synthesis. 2017;15(8):2153–81.
Saraiva S, Guthrie E, Walker A, Trigwell P, West R, Shuweidi F, Crawford M, Fossey M, Hewison J, Murray CC, Hulme C. The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study. BMC Health Serv Res. 2020;20(1):1–1.
doi: 10.1186/s12913-020-05165-x
General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81(3):14–8.