Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T07:37:01.090Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  04 December 2017

Stephen Parker Open the ORCID record for Stephen Parker [Opens in a new window] ,
Frances Dark ,
Ellie Newman ,
Dominic Hanley ,
William McKinlay  and
Carla Meurk
Stephen Parker*
Affiliation:
Rehabilitation ACU, Metro South Addiction and Mental Health Service (MSAMHS), Brisbane, Australia University of Queensland, School of Public Health, Herston, Australia
Frances Dark
Affiliation:
Rehabilitation ACU, Metro South Addiction and Mental Health Service (MSAMHS), Brisbane, Australia University of Queensland, School of Public Health, Herston, Australia
Ellie Newman
Affiliation:
Rehabilitation ACU, Metro South Addiction and Mental Health Service (MSAMHS), Brisbane, Australia
Dominic Hanley
Affiliation:
Rehabilitation ACU, Metro South Addiction and Mental Health Service (MSAMHS), Brisbane, Australia
William McKinlay
Affiliation:
Rehabilitation ACU, Metro South Addiction and Mental Health Service (MSAMHS), Brisbane, Australia
Carla Meurk
Affiliation:
University of Queensland, School of Public Health, Herston, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Australia
*
*Address for correspondence: Stephen Parker, 128 Main Street, Redland Bay, Queensland 4165, Australia. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims.

Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers’ expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them. We explored consumer understandings and expectations of three recovery-oriented community-based residential mental-health rehabilitation units using semi-structured interviews; two of these units were trialling a staffing model integrating peer support with clinical care.

Methods.

Twenty-four consumers completed semi-structured interviews with an independent interviewer during the first 6 weeks of their stay at the rehabilitation unit. Most participants had a primary diagnosis of schizophrenia or a related psychotic disorder (87%). A pragmatic approach to grounded theory guided the analysis, facilitating identification of content and themes, and the development of an overarching conceptual map.

Results.

The rehabilitation units were considered to provide a transformational space and a transitional place. The most common reason given for engagement was housing insecurity or homelessness rather than the opportunity for rehabilitation engagement. Differences in expectations did not emerge between consumers entering the clinical and integrated staffing model sites.

Conclusions.

Consumers understand the function of the rehabilitation service they are entering. However, receiving rehabilitation support may not be the key driver of their attendance. This finding has implications for promoting consumer engagement with rehabilitation services. The absence of differences between the integrated and clinical staffing models may reflect the novelty of the rehabilitation context. The study highlights the need for staff to find better ways to increase consumer awareness of the potential relevance of evidence-based rehabilitation support to facilitating their recovery.

Keywords

Qualitative researchrehabilitationresidential servicesschizophreniaservice-user perspectives
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 4 , August 2019 , pp. 408 - 417
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Australian Health Ministers Advisory Council (2013). A National Framework for Recovery-Oriented Mental Health Services: Guide for Practitioners and Providers. Commonwealth of Australia: Canberra.Google Scholar
Barbato, A, Agnetti, G, D'Avanzo, B, Frova, M, Guerrini, A, Tettamanti, M (2007). Outcome of community-based rehabilitation program for people with mental illness who are considered difficult to treat. Journal of Rehabilitation Research and Development 44, 775–783.Google Scholar
Bright, FA, Kayes, NM, Worrall, L, McPherson, KM (2015). A conceptual review of engagement in healthcare and rehabilitation. Disability and Rehabilitation 37, 643–654.Google Scholar
Buck, PW, Alexander, LB (2006). Neglected voices: consumers with serious mental illness speak about intensive case management. Administration and Policy in Mental Health and Mental Health Services Research 33, 470–481.Google Scholar
Chopra, P, Herrman, HE (2011). The long-term outcomes and unmet needs of a cohort of former long-stay patients in Melbourne, Australia. Community Mental Health Journal 47, 531–541.Google Scholar
Cook, S, Mundy, T, Killaspy, H, Taylor, D, Freeman, L, Craig, T, King, M (2016). Development of a staff training intervention for inpatient mental health rehabilitation units to increase service users’ engagement in activities. British Journal of Occupational Therapy 79, 144–152.Google Scholar
Csipke, E, Papoulias, C, Vitoratou, S, Williams, P, Rose, D, Wykes, T (2016). Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods. Journal of Mental Health 25, 114–121.Google Scholar
Dicicco-Bloom, B, Crabtree, BF (2006). The qualitative research interview. Medical Education 40, 314–321.Google Scholar
Dudzik, K (2011). A Systematic Review of Empirical Studies Examining the Patient Outcomes of Deinstitutionalization in Community versus Institutional Settings. The Adler School of Professional Psychology: ProQuest LLC (2013): Ann Arbor, MI.Google Scholar
Gee, A, McGarty, C, Banfield, M (2016). Barriers to genuine consumer and carer participation from the perspectives of Australian systemic mental health advocates. Journal of Mental Health 25, 231–237.Google Scholar
Goering, PNRNP, Streiner, DLPC (2015). Putting housing first: the evidence and impact. Canadian Journal of Psychiatry 60, 465–466.Google Scholar
Holding, JC, Gregg, L, Haddock, G (2016). Individuals’ experiences and opinions of psychological therapies for psychosis: a narrative synthesis. Clinical Psychology Review 43, 142–161.Google Scholar
Hungerford, C, Fox, C (2014). Consumer's perceptions of recovery-oriented mental health services: an Australian case-study analysis. Nursing and Health Sciences 16, 209–215.Google Scholar
Johnson, G, Parkinson, S, Parsell, C (2012). Policy shift or program drift? Implementing Housing First in Australia, AHURI Final Report No. 184. Australian Housing and Urban Research Institute Limited, Melbourne: Melbourne.Google Scholar
Karnieli-Miller, O, Strier, R, Pessach, L (2009). Power relations in qualitative research. Qualitative Health Research 19, 279–289.Google Scholar
Killaspy, H, Rambarran, D, Bledin, K (2008). Mental health needs of clients of rehabilitation services: a survey in one trust. Journal of Mental Health 17, 207–218.Google Scholar
Kroken, RA, Johnsen, E, Ruud, T, Wentzel-Larsen, T, Jorgensen, HA (2009). Treatment of schizophrenia with antipsychotics in Norwegian emergency wards, a cross-sectional national study. BMC Psychiatry 9, 24.Google Scholar
Le Boutillie, C, Chevalier, A, Lawrence, V, Leamy, M, Bird, VJ, Macpherson, R, Williams, J, Slade, M (2015). Staff understanding of recovery-orientated mental health practice: a systematic review and narrative synthesis. Implementation Science 10, 87.Google Scholar
McKenna, B (2017). Further reflections on recovery-oriented mental health practice in a community care unit: a response. Journal of Forensic Nursing 13, 89–90.Google Scholar
McKenna, B, Oakes, J, Fourniotis, N, Toomey, N, Furness, T (2016). Recovery-oriented mental health practice in a community care unit: an exploratory study. Journal of Forensic Nursing 12, 167–175.Google Scholar
Meaden, A, Hacker, D, de Villiers, A, Carbourne, J, Paget, A (2012). Developing a measurement of engagement: the residential rehabilitation engagement scale for psychosis. Journal of Mental Health 21, 182–191.Google Scholar
Meehan, T, Stedman, T, Parker, S, Curtis, B, Jones, D (2017). Comparing clinical and demographic characteristics of people with mental illness in hospital- and community-based residential rehabilitation units in Queensland. Australian Health Review 41, 139–143.Google Scholar
Moran, GS, Baruch, Y, Azaiza, F, Lachman, M (2016). Why do mental health consumers who receive rehabilitation services, are not using them? A qualitative investigation of users’ perspectives in Israel. Community Mental Health Journal 52, 859–872.Google Scholar
Padgett, DK, Henwood, B, Abrams, C, Davis, A (2008). Engagement and retention in services among formerly homeless adults with co-occurring mental illness and substance abuse: voices from the margins. Psychiatric Rehabilitation Journal 31, 226–233.Google Scholar
Parker, S, Dark, F, Newman, E, Korman, N, Meurk, C, Siskind, D, Harris, M (2016 a). Longitudinal comparative evaluation of the equivalence of an integrated peer-support and clinical staffing model for residential mental health rehabilitation: a mixed methods protocol incorporating multiple stakeholder perspectives. BMC Psychiatry 16, 179.Google Scholar
Parker, S, Dark, F, Vilic, G, McCann, K, O'Sullivan, R, Doyle, C, Lendich, B (2016 b). Integrated staffing model for residential mental health rehabilitation. Mental Health and Social Inclusion 20, 92–100.Google Scholar
Parker, S, Dark, F, Newman, E, Korman, N, Rasmussen, Z, Meurk, C (2017 a). Reality of working in a community-based, recovery-oriented mental health rehabilitation unit: a pragmatic grounded theory analysis. International Journal of Mental Health Nursing 26, 355–365.Google Scholar
Parker, S, Siskind, D, Meurk, C (2017 b). Further reflections on recovery-oriented mental health practice in a community care unit. Journal of Forensic Nursing 13, 87–88.Google Scholar
Parker, S, Dark, F, Meurk, C, Newman, E (2017). Understanding consumers’ initial expectations of community-based residential mental health rehabilitation in the context of past experiences of care: a pragmatic grounded theory analysis. Unpublished manuscript.Google Scholar
QSR (2016). NVivo Qualitative Data Analysis Software – Version 11. QSR International Pty Ltd: Doncaster, Victoria.Google Scholar
Queensland Health (2015). Community Care Unit Model of Service: Queensland Public Health Services, February 2015. State of Queensland (Queensland Health): Queensland.Google Scholar
Smith, TE, Easter, A, Pollock, M, Pope, LG, Wisdom, JP (2013). Disengagement from care: perspectives of individuals with serious mental illness and of service providers. Psychiatric Services 64, 770–775.Google Scholar
Thomas, K.A., Rickwood, D.J. (2016). Facilitators of recovery for step-up and step-down clients of a sub-acute residential mental health service. Journal of Mental Health 25, 343–349.Google Scholar
Supplementary material: PDF

Parker et al supplementary material

Parker et al supplementary material 1

Download Parker et al supplementary material(PDF)
PDF 27.6 KB
Supplementary material: PDF

Parker et al supplementary material

Parker et al supplementary material 2

Download Parker et al supplementary material(PDF)
PDF 61.4 KB