Dr JAMES ROE JAMES.ROE@NOTTINGHAM.AC.UK
RESEARCH FELLOW
Experiences and impact of psychiatric inpatient admissions far away from home: a qualitative study with young people, parents/carers and healthcare professionals
Roe, James; Holland, Josephine; Burn, Anne-Marie; Hopkin, Elinor; Wild, Lorna; Fisher, Michelle; Nazir, Saeed; Ford, Tamsin; Dubicka, Bernadka; James, Anthony; Tuomainen, Helena; Fung, Nicole; Horton, Kate; Wagner, Adam P.; Morriss, Richard; Sayal, Kapil
Authors
Dr JOSEPHINE HOLLAND Josephine.Holland@nottingham.ac.uk
CLINICAL ASSISTANT PROFESSOR
Anne-Marie Burn
Elinor Hopkin
Lorna Wild
Michelle Fisher
Saeed Nazir
Tamsin Ford
Bernadka Dubicka
Anthony James
Helena Tuomainen
Nicole Fung
Kate Horton
Adam P. Wagner
Professor RICHARD MORRISS richard.morriss@nottingham.ac.uk
PROFESSOR OF PSYCHIATRY AND COMMUNITY MENTAL HEALTH
Professor KAPIL SAYAL kapil.sayal@nottingham.ac.uk
PROFESSOR OF CHILD AND ADOLESCENT PSYCHIATRY
Abstract
Background: There are significant clinical, policy and societal concerns about the impact on young people (YP), from admission to psychiatric wards far from home. However, research evidence is scarce.
Aims: To investigate the impact of at-distance admissions to general adolescent units, from the perspectives of YP, parents/carers and healthcare professionals (HCPs) including service commissioners, to inform clinical practice, service development and policy.
Method: Semistructured interviews with purposive samples of YP aged 13–17 years (n=28) and parents/carers (n=19) across five large regions in England, and a national sample of HCPs (n=51), were analysed using a framework approach.
Results: There was considerable agreement between YP, parents/carers and HCPs on the challenges of at-distance admissions. YP and parents/carers had limited or no involvement in decision-making processes around admission and highlighted a lack of available information about individual units. Being far from home posed challenges with maintaining home contact and practical/financial challenges for families visiting. HCPs struggled with ensuring continuity of care, particularly around maintaining access to local clinical teams and educational support. However, some YP perceived separation from their local environment as beneficial because it removed them from unhelpful environments. At-distance admissions provided respite for some families struggling to support their child.
Conclusions: At-distance admissions lead to additional distress, uncertainty, compromised continuity of care and educational, financial and other practical difficulties, some of which could be better mitigated. For a minority, there are some benefits from such admissions.
Clinical implications: Standardised online information, accessible prior to admission, is needed for all Child and Adolescent Mental Health Services units. Additional practical and financial burden placed on families needs greater recognition and consideration of potential sources of support. Policy changes should incorporate findings that at-distance or adult ward admissions may be preferable in certain circumstances.
Citation
Roe, J., Holland, J., Burn, A.-M., Hopkin, E., Wild, L., Fisher, M., Nazir, S., Ford, T., Dubicka, B., James, A., Tuomainen, H., Fung, N., Horton, K., Wagner, A. P., Morriss, R., & Sayal, K. (2024). Experiences and impact of psychiatric inpatient admissions far away from home: a qualitative study with young people, parents/carers and healthcare professionals. BMJ Mental Health, 27(1), Article e300991. https://doi.org/10.1136/bmjment-2024-300991
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 8, 2024 |
Online Publication Date | Apr 25, 2024 |
Publication Date | 2024-01 |
Deposit Date | Mar 14, 2024 |
Publicly Available Date | Mar 14, 2024 |
Journal | BMJ Mental Health |
Electronic ISSN | 2755-9734 |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 27 |
Issue | 1 |
Article Number | e300991 |
DOI | https://doi.org/10.1136/bmjment-2024-300991 |
Keywords | Child & adolescent psychiatry |
Public URL | https://nottingham-repository.worktribe.com/output/32463818 |
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Copyright Statement
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. Published by BMJ.
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