Factors affecting experiences of care and service delivery for people with severe and enduring mental health problems

Abstract

AbstractThe University of ManchesterCandidate: Sarah WoodwardA thesis submitted to The University of Manchester for the degree of Clinical Psychology Doctorate in the Faculty of Biology, Medicine and HealthThesis title: Factors affecting experiences of care and service delivery for people with severe and enduring mental health problemsThis thesis explored factors associated with experience of receiving and delivery care for people with severe mental health problems. The specific aims were (i) to provide an up-to-date systematic review of the factors associated with service users' satisfaction with psychiatric mental health services and (ii) to explore Early Intervention in Psychosis staff members' views of the barriers and facilitators to smooth transition to other services. Paper one reports on a systematic review of the literature relating to satisfaction with inpatient psychiatric services. An extensive search process resulted in 32 papers, which were reviewed and critically appraised. Findings showed that satisfaction was influenced by a number of factors, most notably experiences of the therapeutic relationship, voluntary admission and residing on an open ward were positively associated with satisfaction, while experiences of coercion, or witnessing aggression on the ward was negatively associated with reported satisfaction. Paper two reports on a qualitative investigation of Early Intervention staff members' views of the barriers and facilitators faced during discharge to other services. This is a novel area of research, and presents important findings. Eighteen staff members were interviewed, and transcribed interviews were subject to thematic analysis. The results show that staff experienced significantly more barriers, than facilitators, suggesting there are difficulties associated with the discharge process. Staff reported a high number of delayed discharges, with service pressures meaning that service users were prevented from moving on to other services. The ending of the therapeutic relationship was also seen as a barrier, as staff reported difficulty with this loss. Joint working between Early Intervention staff members and staff from other teams was seen to facilitate the transition process. Paper three presents a critical appraisal of the process of developing this thesis, including reflections on professional and personal development.

Date of Award	1 Aug 2017
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Katherine Berry (Supervisor), Dawn Edge (Supervisor) & Sandra Bucci (Supervisor)