OP MH inpatient discharge experiences v5
Research type
Research Study
Full title
Older people’s experience of discharge from mental health inpatient settings: a qualitative exploration of patient and nurse perspectives
IRAS ID
330114
Contact name
David Grinter
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
0 years, 5 months, 31 days
Research summary
Summary of Research
Reducing people’s hospital stays is a key priority for NHS Scotland, particularly for older people (OP). 40% of people in mental health hospitals (MHH) are OP and 40% of OP are discharged to a higher level of care than before admission. Discharge research thus far has focused on rates of suicide and re-admission with little research on patient experience. The Scottish Government (2021) introduced two new programmes – ‘Interface Care’ and ‘Discharge without Delay’ – aiming to explore alternatives to admission and improve discharge processes for required admissions. This indicates a need for research to explore and understand issues associated with discharge.
This study aims to explore and understand OP’s experience of being discharged from MHH, by asking OP themselves, as well as registered mental health nurses (RMN).
Our research questions are:
1. What are OP’s experiences of being discharged from a MHH?
2. What aspects of the discharge process do they describe as helpful or unhelpful?
3. What are RMN’s understanding of how OP experience discharge?
4. What similarities and differences are reported by patients and RMN's?
People invited to take part in the study will be:
1. OP (aged 65 and over) discharged from an OP MHH ward in NHS Greater Glasgow and Clyde, within the last 1 – 12 months. They will be recruited through community mental health teams and their care coordinator will have deemed them as psychologically well enough to participate. They will be invited to interview to discuss their recent experience of discharge.
2. RMN’s working in OP MHH. They will be invited to a one-off focus group to discuss the hospital discharge and transition process, particularly, patient experience of it.
We hope that gaining a better understanding of OP’s discharge experience will assist with improving discharge planning, aid service development and inform discharge policies.Summary of Results
Six key themes were identified from patient
interviews:
1. Discharge is a gradual process, something that is worked up to. This involves an initial conversation about discharge; passes; getting the right medication; an occupational therapy assessment of day-to-day functioning and being assigned a community psychiatric nurse (CPN).
2. The importance of patient involvement in discharge planning. This includes working collaboratively with doctors and feeling empowered to make decisions.
3. Communication: Participants felt communication from hospital staff to patients and their families/carers, regarding plans for passes and discharge, could be improved.
4. The importance of social support: Support from family, friends, neighbours and religious and social groups were an important part of the discharge process.
5. The importance of community mental health support: Participants spoke of the value of knowing support was both available and accessible from community mental health services, particularly CPN support.
6. The importance of readiness for discharge: Not all participants felt ready for discharge and this impacted on the way they felt after being discharged. The above themes played appeared to play role in whether people felt ready to be discharged.
The results of this research help services to better understand how older people experience discharge from a psychiatric hospital, and how services could improve this process to ensure patients are involved and supported appropriately. It also shows the importance of asking patients about their experience of mental health care.REC name
West of Scotland REC 4
REC reference
24/WS/0003
Date of REC Opinion
22 Feb 2024
REC opinion
Further Information Favourable Opinion