Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-20T13:27:51.889Z Has data issue: false hasContentIssue false
  • English
  • Français

Understand me; believe in me; accept me as I am: perceptions of psychiatry of later life service

Published online by Cambridge University Press:  01 May 2014

T. O. Grady ,
U. Gilrane-McGarry ,
G. Sweeney ,
M. Cryan  and
G. McCarthy
T. O. Grady*
Affiliation:
Department of Mental Health, St Angela’s College, Sligo, Ireland
U. Gilrane-McGarry
Affiliation:
Department of Nursing, Health Sciences and Disability Studies, St Angela’s College, Sligo, Ireland
G. Sweeney
Affiliation:
Department Psychiatry of Later Life, Sligo-Leitrim Mental Health Services, Sligo, Ireland
M. Cryan
Affiliation:
Department Psychiatry of Later Life, Sligo-Leitrim Mental Health Services, Sligo, Ireland
G. McCarthy
Affiliation:
Sligo-Leitrim Mental Health Services, Sligo Medical Academy and NUI Galway, Sligo, Ireland
*
*Address for correspondence: T. O. Grady, RPN; RGN, RNT; MSHc in Health Sciences (Education), BNs in Nursing, Diploma in Addiction Studies, PG Diploma in Bereavement Studies, Lecturer in Mental Health, St Angela’s College, Sligo, Ireland. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Context

The emergence of mental health services for older people is a relatively recent development in Ireland. Therefore, it is important to determine strengths and limitations of this modern-day care service. A starting point is to enquire from those who have been in receipt of their service and/or their respective carers.

Aim

This study aims to identify and describe the perceptions and experiences of past service users (SUs) and their carers, while in receipt of services from an acute mental health day hospital for Psychiatry of Later Life and to explore their needs/supports.

Methods

A qualitative, exploratory, descriptive design was employed. Purposive sampling achieved a sample of 13 SUs and six carers. Inclusion criteria set were that the SU had a diagnosis of a psychiatric disorder; had the capacity to make an informed consent and communicate verbally and the SU was discharged from the service between January and July 2011. Finally, carers of SUs in receipt of the service during this time were also included. Data were subjected to thematic, field analysis.

Findings

‘Person centredness’ emerged as an overarching theme. Six inter-related subthemes revealing how SUs and carers viewed their care emerged from the interviews: ‘therapeutic engagement’; ‘preservation of self-integrity’; ‘collaborative care’; ‘integrated care’; ‘social gains’; and ‘the relationship between the expectation, subsequent engagement and the perceived outcome of care’.

Conclusions

Findings concluded that high levels of care exist within this service. Strengths lie in the development of a therapeutic relationship, preservation of self-integrity, social gains and robust elements of person-centred holistic, integrated and collaborative care

Recommendations support the enhancement of a cohesive planned approach to admission, discharge/transition (integrated pathway).

Keywords

Carersday hospitalolder personpsychiatryservice perception
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 2 , June 2014 , pp. 97 - 106
Copyright
© College of Psychiatrists of Ireland 2014 

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

Ashaye, A, Seneviratna, K, Shergill, S (1999). Do the Health of the Nation Scales predict outcome in the elderly mentally ill - a one year follow-up. Journal of Mental Health. 8, 615–620.Google Scholar
Audit Commission (2000). Forget Me Not. National Report on Mental Health Services for Older People. Audit Commission for Local Authorities and the National Health Service in England and Wales: London.Google Scholar
Bauer, MS, McBride, L, Williford, WO, Glick, H, Kisonian, B, Altshuler, L (2006). Collaborative care for bipolar disorder: part 1 – intervention and implementation in a randomised effective trial. Psychiatric Services 57, 927–936.CrossRefGoogle Scholar
Belcher, NV, Fried, TR, Agostini, J, Tinetti, ME (2006). Views of older adults on patient participation in medication-related decision making. Journal of General Internal Medicine 21, 298–303.CrossRefGoogle ScholarPubMed
Ben-Porath, DD (2004). Strategies for securing commitment to treatment from individuals diagnosed with borderline personality disorder. Journal of Contemporary Psychotherapy 34, 247–263.CrossRefGoogle Scholar
Bentley, J (2003). Older people as health service consumers 4: disempowered or disinterested? British Journal of Community Nursing 8, 181–187.CrossRefGoogle ScholarPubMed
Bischoff, RJ, Springer, PR, Reisbig, AMJ, Lyons, S, Likcani, A (2012). Training for collaboration: collaborative practice skills for mental health professionals. Journal of Marital and Family Therapy 38, 199–210.CrossRefGoogle ScholarPubMed
Boaz, A, Hayden, C, Bernard, M (1999). Attitudes and Aspirations of Older People: A Review of the Literature. Department of Social Security: London.Google Scholar
Bramesfeld, A (2003). Service provision for elderly depressed persons and political and professional awareness for this subject: a comparison of six European countries. International Journal of Geriatric Psychiatry 18, 392–401.CrossRefGoogle ScholarPubMed
Brooker, D (2007). Person Centred Dementia Care: Making Services Better. Jessica Kingsley Publishers: London.Google Scholar
Burnard, P (1991). A method of analyzing interview transcripts in qualitative research. Nurse Education Today 11, 461–466.CrossRefGoogle Scholar
Butler, MH, Harper, JM, Brimhall, AS (2011). A primer on the evolution of therapeutic engagement in MFT: understanding and resolving the dialectic tension of alliance and neutrality. Part 2 –recommendations: dynamic neutrality through multipartiality and enactments. The American Journal of Family Therapy 39, 193–213.CrossRefGoogle Scholar
Butterworth, C (2012). How to achieve a person-centred writing style in care plans. Nursing Older People 24, 21–26.CrossRefGoogle ScholarPubMed
Canuto, A, Meiler-Mititelu, C, Herrmann, FR, Delaloye, C, Giannakopoulos, P, Weber, K (2008). Longitudinal assessment of psychotherapeutic day hospital treatment for elderly patients with depression. International Journal of Geriatric Psychiatry. 23, 949–956.CrossRefGoogle ScholarPubMed
Cheng-Hsui, C, Ya-Hui, C, Feng-Chun, F (2012). Adolescents and leisure activities: the impact of expectation and experience on service satisfaction. Social Behaviour and Personality: An International Journal 40, 259–265.Google Scholar
Coulter, A (2006). Engaging Patients in their Health Care: How is the UK Doing Relative to Other Countries?. Picker Institute Europe: Oxford.Google Scholar
Dadds, MR (1997). Conduct disorder. In Handbook of Prevention and Treatment with Children and Adolescents (ed. R. T. Ammerman and M. Hersen), Wiley: New York, 521–550.Google Scholar
Day, JC, Bentall, RP, Roberts, C, Randall, F, Rogers, A, Cattell, D, Healy, D, Rae, P, Power, C (2005). Attitudes toward antipsychotic medication: the impact of clinical variables and relationships with health professionals. Archives of General Psychiatry. 62, 717–724.CrossRefGoogle ScholarPubMed
Davies, E, Philpot, M (2004). ‘God’s waiting room’: how do older people with affective disorder view day hospital care? International Journal of Geriatric Psychiatry 19, 592–593.CrossRefGoogle ScholarPubMed
Department of Health (1984). The Psychiatric Services: Planning for the Future – Report of a Study Group on the Development of the Psychiatric Services. Stationary Office: Dublin.Google Scholar
Department of Health and Children (2006). Vision for Change: Report of the Expert Group on Mental Health Policy. Stationary Office: Dublin.Google Scholar
Dolder, CR, Lacro, JP, Leckband, S, Jeste, DV (2003). Interventions to improve antipsychotic medication adherence: review of recent literature. Journal of Clinical Psychopharmacology 23, 389–399.CrossRefGoogle ScholarPubMed
Eldh, AC, Ekman, I, Ehnfors, M (2006). Conditions for patient participation and non-participation in healthcare. Nursing Ethics 13, 503–514.CrossRefGoogle Scholar
Forchuk, C, Westwell, J, Martin, M (1998). Factors influencing movement of chronic psychiatric patients from the orientation to the working phase of the nurse-client relationship on an in-patient unit. Perspectives in Psychiatric Care 34, 36–44.CrossRefGoogle Scholar
Frank, AF, Gunderson, JG (1990). The role of therapeutic alliance in the treatment of schizophrenia. Archives of General Psychiatry 47, 228–236.CrossRefGoogle ScholarPubMed
Furness, L, Simpson, R, Chakrabarti, S, Dennis, MS (2000). The comparison of elderly day care and day hospital attenders in Leicestershire: client profile, carer stress and unmet need. Aging and Mental Health 4, 324–329.CrossRefGoogle Scholar
Garlipp, P, Bruggemann, BR, Seidler, KP (2007). Day hospital treatment of depressive patients. Psychiatrische Praxis 34, 273–276.CrossRefGoogle ScholarPubMed
Graneheim, UH, Lundman, B (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24, 105–112.CrossRefGoogle ScholarPubMed
Greenhalgh, T (1997). How to read a paper: papers that summarise other papers (systematic reviews and meta-analyses). British Medical Journal 315, 180–183.CrossRefGoogle Scholar
Health Service Executive (2012 a). Vision for Change Working Group: Advancing Community Mental Health Services in Ireland – Guidance Papers. Office of the Assistant National Director, Mental Health: Kildare.Google Scholar
Health Service Executive (2012 b). A Vision for Psychiatric/Mental Health Nursing: A Shared Journey for Mental Health Care in Ireland. Office of the Nursing and Midwifery Services Director: Dublin.Google Scholar
Higgins, A (2008). A Recovery Approach within the Irish Mental Health Services: A Framework for Development. Mental Health Commission: Dublin.Google Scholar
Holloway, I, Wheeler, S (1996). Qualitative Research in Nursing. Blackwell Publishing: Oxford.Google Scholar
Hunter, E (2004). Commonality, difference and confusion: changing constructions of indigenous mental health. Australian E-Journal for the Advancement of Mental Health 3, 3.CrossRefGoogle Scholar
International Council of Nurses (ICN) (2003). Ethical Guidelines for Nursing Research. ICN: Geneva.Google Scholar
Kallert, TW, Glockner, M, Priebe, S, Briscoe, J, Rymaszewska, J, Adamowski, T, Nawka, P, Reguliova, H, Raboch, J, Howardova, A, Schutzwohl, M (2004 a). A comparison of psychiatric day hospitals in five European countries. Social Psychiatry and Psychiatric Epidemiology 39, 777–788.CrossRefGoogle ScholarPubMed
Kallert, TW, Matthes, C, Glockner, M (2004 b). Acute psychiatric day hospital treatment: is the effectiveness of this treatment approach still questionable? Psychiatrische Praxis 31, 409–419.CrossRefGoogle ScholarPubMed
Lariviere, N, Desrosiers, J, Tousignant, M, Boyer, R (2011). Multifaceted impact evaluation of a day hospital compared to hospitalisation on symptoms, social participation, service satisfaction and costs associated to service use. International Journal of Psychiatry in Clinical Practice 15, 228–240.CrossRefGoogle Scholar
Link, BG, Struening, EL, Rahev, M (1997). On stigma and its consequences: evidence from a longitudinal study of men with dual diagnosis of mental illness and substance abuse. Journal of Health and Social Behaviour 38, 177–190.CrossRefGoogle ScholarPubMed
Lyttle, DJ, Ryan, A (2010). Factors influencing older patients’ participation in care: a review of the literature. International Journal of Older People Nursing 5, 274–282.CrossRefGoogle Scholar
MacKenzie, CS (2006). Evaluation of a psychiatric day hospital program for elderly patients with mood disorders. International Psychogeriatrics. 18, 631–641.CrossRefGoogle ScholarPubMed
McCance, T, McCormack, B, Dewing, J (2011). Developing person-centred care: addressing contextual challenges through practice development. Journal of Issues in Nursing 16, 3.Google Scholar
Mental Health Commission (2010). Teamwork within Mental Health Services in Ireland. Mental Health Commission: Dublin.Google Scholar
Neale, M, Rosenheck, R (1995). Therapeutic alliance and outcome in a VA intensive case management program. Psychiatric Service 46, 719–721.Google Scholar
O’Brien, A, Fahmy, R, Singh, SP (2009). Disengagement from mental health services. Social Psychiatry and Psychiatric Epidemiology 44, 558–568.CrossRefGoogle ScholarPubMed
Padoani, W, Buono, MD, Marietta, P, Scocco, P, Zaghi, PC, De Leo, D (2000). Influence of cognitive status on the sexual life of 352 elderly Italians aged 65–105 years. Gerontology 46, 258–265.CrossRefGoogle ScholarPubMed
QSR International Pty Ltd (2011). NVivo qualitative data analysis software; Version 9, 2011.Google Scholar
Reilly, S, Venables, D, Hughes, J, Challis, D, Abendstern, M (2006). Standards of care in day hospitals and day centres: a comparison of services for older people with dementia. International Journal of Geriatric Psychiatry 21, 460–468.CrossRefGoogle ScholarPubMed
Reeve, J, Lloyd-Williams, M, Payne, S, Dowrick, C (2009). Towards a re-conceptualization of the management of distress in palliative care patients: the self-integrity model. Progress in Palliative Care 17, 51–60.CrossRefGoogle Scholar
Rogers, CR (1951). Client-Centered Therapy. London: Constable.Google Scholar
Røsvik, J, Kirkevold, M, Engedal, K, Brooker, D, Kirkevold, Ø (2011). A model for using the VIPS Framework for person-centred care for persons with dementia in nursing homes: a qualitative evaluative study. International Journal of Older People Nursing 6, 227–236.CrossRefGoogle Scholar
Safran, JD, Segal, ZV (1996). Interpersonal Process in Cognitive Therapy. Basic Books: New York.Google Scholar
Sahlsten, JM, Larsson, IE, Plos, KAE, Lindencrona, CSC (2005). Hindrance for participation in nursing care. Scandanavian Journal of Caring Science 19, 223–229.CrossRefGoogle ScholarPubMed
Scott, KL, King, CB (2007). Resistance, reluctance and readiness in perpetrators of abuse against women and children. Trauma, Violence and Abuse 8, 401–417.CrossRefGoogle ScholarPubMed
Secker, J, Gulliver, P, Peck, E, Robinson, J, Bell, R, Hughes, J (2001). Evaluation of community mental health services: comparison of a primary care mental health team and an extended day hospital service. Health and Social Care in the Community 9, 495–503.CrossRefGoogle Scholar
Seidler, KP, Garlipp, P, Machleidt, W, Haltenhof, H (2006). Treatment concepts of day hospitals for general psychiatric patients: findings from a national survey in Germany. European Psychiatry 21, 110–117.CrossRefGoogle ScholarPubMed
Steele, CM (1988). The psychology of self-affirmation: sustaining the integrity of then self. In Advances in Experimental Social Psychology (ed. L. Berkowitz). vol. 21, pp. 261–302. Academic Press: New York.Google Scholar
Stringer, B, van Meijel, B, Koekkoek, B, Kerkhof, A, Beekman, A (2011). Collaborative care for patients with severe borderline and nos personality disorders: a comparative multiple case study on processes and outcomes. BMC Psychiatry 11, 102.CrossRefGoogle ScholarPubMed
Svensson, B, Hansson, L (1999). Therapeutic alliance in cognitive therapy for schizophrenic and other long-term mentally ill patients: development and relationship to outcome in an in-patient treatment programme. Acta Psychiatrica Scandinavia 99, 281–287.CrossRefGoogle Scholar
Tetley, A, Jinks, M, Huband, N, Howells, K (2011). A systematic review of measures of therapeutic engagement in psychosocial and psychological treatment. Journal of Clinical Psychology 67, 927–941.CrossRefGoogle ScholarPubMed
Trjntje, YG, van Meijel, B, Goossens, PJJ, Renes, J, Beekman, ATF, Kupka, RW (2011). Collaborative care for patients with bipolar disorder: a randomised control trial. BioMed Central Psychiatry 11, 133.Google Scholar
Vijayalakshmy, P, Hebert, C, Green, S, Ingram, CL (2011). Integrated multidisciplinary treatment teams; a mental health model for outpatient settings in the military. Military Medicine 176, 986–990.Google ScholarPubMed
Watsford, C, Rickwood, D, Vanags, T (2013). Exploring young people’s expectations of a youth mental health care service. Early Intervention in Psychiatry 7, 131–137.CrossRefGoogle ScholarPubMed