Disengaging from acute inpatient psychiatric care: a description of service users' experiences and views


P. Nolan
Stallbrook Hall Granary
Crossing Lane
Stafford ST18 9LW
E-mail: stallbrook@googlemail.com


Accessible summary

  • • Movement between community and inpatient care can be, for some service users, much more unsettling than previously thought, largely because admissions are for custodial reasons than therapeutic ones.
  • • The opportunity and ability to form relationships with other service users and staff would appear to be one of the most significant factor in determining the success or otherwise of the inpatient experience.
  • • Inpatient interventions should aim to build on relationships by focusing predominantly on preparing the person for life after discharge and the multiple difficulties they may encounter.
  • • Greater efforts should be made to incorporate the experiences of service users into improvement plans for acute inpatient care in the future.


The growing number of people worldwide with mental health problems is increasing and making intensive demands on existing services. Recent reorganizations of healthcare provision in the UK have focused predominantly on administrative efficiency, standardization and cost-effectiveness. Although little evidence exists that reorganizations, per se, directly result in improved health nationally, nevertheless, organizational change coupled with improved care provision can have a considerable impact on the mental health of people. It is known that service users want person-centred help with improving their confidence, autonomy and cognitive and social skills so as to be able to manage their lives within the social context in which they live. In this study, semi-structured interviews were used to explore service users' expectations and experiences of acute inpatient care and the early post-discharge period. While the social environment of the wards was seen by many as conducive to promoting safety and interpersonal relationships, others found the experience lacking in assisting them to resume their lives post discharge. If acute care is to become more than a mechanism for addressing and containing risk, better targeted interventions are required to help individuals find strategies that are transferable to the context of their ‘real’ lives. A number of factors that were identified by respondents in this study are identified and discussed.