Abstract
Psychiatric day hospitals offer intensive short-term multidisciplinary treatment. No study has examined in more depth the impact of this therapeutic experience in the life of participants and what they retained from their participation after discharge. A qualitative design using semi-structured individual interviews was completed with 18 participants of different gender, age and diagnosis, treated in a day hospital, 6 months after discharge. Interview themes addressed events and changes since discharge, learnings retained, appreciated components and suggestions. Results showed that the day hospital experience was particularly helpful to improve symptoms and relationship with self. It activated a self-transformation process that continued afterwards. Termination created for many an abrupt void. Issues at stake during the first 6 months were continuity of care, social support and putting learnings into practice. The program offered at the day hospital was generally appreciated but management of the waiting time and linkage to outpatient services needed improvement.
Similar content being viewed by others
References
Casarino JP, Wilner M, Maxey JT: American association for partial hospitalization (AAPH) standards and guidelines for partial hospitalization. International Journal of Partial Hospitalization 1:5–21, 1982
Larivière N, Melançon L, Fortier L, et al.: A qualitative analysis of clients’ evaluation of a psychiatric day hospital. Canadian Journal of Community Mental Health, 28:165–179, 2009
Horvitz-Lennon M, Normand S-LT, Graccione P, et al.: Partial versus full hospitalization for adults in psychiatric distress: A systematic review of the published literature (1957-1997). American Journal of Psychiatry 158:676–685, 2001
Marshall M, Crowther R, Almaraz-Serrano A, et al.: Acute day hospital versus admission for acute psychiatric disorders. Health Technology Assessment 5:1–75, 2001
Kallert TW, Priebe S, McCabe R, et al.: Are day hospitals effective for acutely ill psychiatric patients? A European multicenter randomized controlled trial. Journal of Clinical Psychiatry 68:278–287, 2007
Priebe S, Jones G, McCabe R, et al.: Effectiveness and costs of acute day hospital treatment compared with conventional in-patient care/randomised controlled trial. British Journal of Psychiatry 188:243–249, 2006
Glick ID, Fleming L, DeChillo N, et al.: A controlled study of transitional day care for non-chronically-ill patients. American Journal of Psychiatry 143:1551–1556, 1986
Dick PH, Sweeney ML, Crombie IK: Controlled comparison of day-patient and out-patient treatment for persistent anxiety and depression. British Journal of Psychiatry 158:24–27, 1991
Sledge WH, Tebes J, Rakfeldt J, et al.: Day hospital/Crisis respite care versus inpatient car, part I: Clinical outcomes. American Journal of Psychiatry 153:1065–1073, 1996
Elbeck M, Fecteau G: Improving the validity of measures of patient satisfaction with psychiatric care and treatment. Hospital and Community Psychiatry 41:998–1001, 1990
Linder-Pelz S: Toward a theory of patient satisfaction. Social Science and Medicine 16:577–579, 1982
Ruggeri M: Patients’ and relatives’ satisfaction with psychiatric services: The state of the art of its measurement. Social Psychiatry and Psychiatric Epidemiology 29:212–227, 1994
Creswell JW: Qualitative Inquiry & Research Design/Choosing Among Five Approaches. Thousand Oaks, CA, SAGE, 2007
Mirin SM, Namerow MJ: Why study treatment outcome? Hospital and Community Psychiatry 42:1007–1013, 1991
Miles MB, Huberman AM: Qualitative Data Analysis. Thousand Oaks, CA, SAGE Publications, 1994
Poupart J, Deslauriers J-P, Groulx L-H, et al.: La recherche qualitative/Enjeux épistémologiques et méthodologiques. Boucherville, Québec, Canada, Gaëtan Morin Éditeur, 1997
Ware JE Jr, Davies AR: Behavioral consequences of consumer dissatisfaction with medical care. Evaluation and Program Planning 6:291–297, 1983
Corbière M, Lesage A, Lauzon S, et al.: Validation française du questionnaire «Verona Service Satisfaction Scale» VSSS-54F. L’Encéphale 29:110–118, 2003
Ruggeri M, Dall’Agnola R: The development and use of the Verona expectations for care scale (VECS) and the Verona service satisfaction scale (VSSS) for measuring expectations and satisfaction with community-based psychiatric services in patients, relatives and professionals. Psychological Medicine 23:511–523, 1993
Ruggeri M, Lasalvia A, Dall’Agnola R, et al.: Development, internal consistency and reliability of the Verona service satisfaction scale-European version/EPSILON study 7. British Journal of Psychiatry 177(suppl. 39):s41–s48, 2000
Serero M, Gagnon J: Portrait des hôpitaux de jour en psychiatrie adulte au Québec. Québec, Canada, Association des hôpitaux du Québec, 2000
Kielhofner G: Model of Human Occupation/Theory and Application. Philadelphia, PA, Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008
Smith JA, Osborn M: Interpretative Phenomenological Analysis. In: Smith JA (Ed.) Qualitative Psychology: A Practical Guide to Research Methods. Thousand Oaks, CA, SAGE Publications, 2003
Hoge MA, Farrell SP, Munchel ME, et al.: Therapeutic factors in partial hospitalization. Psychiatry 51:199–210,1988
Yalom ID, Leszcz M: The Theory and Practice of Group Psychotherapy. New York, Basic Books, 2005.
Wills TA, Shinar O: Measuring Perceived and Received Social Support. In: Cohen S, Underwood LG, Gottlieb BH (Eds.) Social Support Measurement and Intervention. Oxford, Oxford University Press, 2000
Wilcock AA: Relationship of Occupations to Health and Well-being. In: Christiansen CH, Baum CM (Eds.) Occupational Therapy/Performance, Participation, and Well-Being. Thorofare, NJ, SLACK Inc., 2005
Davidson L, O’Connell MJ, Tondora J, et al.: Recovery in Serious Mental Illness: Paradigm Shift or Shibboleth? In: Davidson L, Harding C, Spaniol L (Eds.) Recovery from Severe Mental Illnesses: Research Evidence and Implications for Practice. Boston, MA, Boston University, Sargent College of Health and Rehabilitation Sciences, Center for Psychiatric Rehabilitation, 2005
Piat M, Sabetti J, Couture A, et al.: What does recovery mean for me? Perspectives of Canadian mental health consumers. Psychiatric Rehabilitation Journal 32 :199–207, 2009
Young SL, Ensing DS: Exploring recovery from the perspective of people with psychiatric disabilities. Psychiatric Rehabilitation Journal 22:219–231, 1999
Roe D, Chopra M: Beyond coping with mental illness: Toward personal growth. American Journal of Orthopsychiatry 73:334–344, 2003
Schreer H: Therapeutic factors in psychiatric day hospital treatment. International Journal of Partial Hospitalization 5:307–319, 1988
Dixon L, Goldberg R, Iannone V, et al.: Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization. Psychiatric Services 60:451–458, 2009
Prince JD: Practices preventing rehospitalization of individuals with schizophrenia. The Journal of Nervous and Mental Disease 194:397–403, 2006
Boyer CA, McAlpine DD, Pottick KJ, et al.: Identifying risk factors and key strategies in linkage to outpatient psychiatric care. American Journal of Psychiatry 157:1592–1598, 2000
Goldacre M, Seagroatt V, Hawton K: Suicide after discharge from psychiatric inpatient care. Lancet 342:283–286, 1993
Reis HT, Collins N: Measuring Relationship Properties and Interactions Relevant to Social Support. In: Cohen S, Underwood LG, Gottlieb BH (Eds.) Social Support Measurement and Intervention. Oxford, Oxford University Press, 2000
Olfson M, Mechanic D, Boyer CA, et al.: Linking inpatients with schizophrenia to outpatient care. Psychiatric Services 49:911–917, 1998
Hendryx M, Green CA, Perrin NA: Social support, activities, and recovery from serious mental illness: STARS study findings. The Journal of Behavioral Health Services & Research 36:320–329, 2009
Aubin G, Hachey R, Mercier C: La signification des activités quotidiennes chez les personnes souffrant de troubles mentaux graves. Canadian Journal of Occupational Therapy 69:218–228, 2002
Bejerholm U, Eklund M: Occupational engagement in persons with schizophrenia: Relationships to self-related variables, psychopathology, and quality of life. American Journal of Psychiatry 61:21–32, 2007
Eklund M, Leufstadius C: Occupational factors and aspects of health and wellbeing in individuals with persistent mental illness living in the community. Canadian Journal of Occupational Therapy 74:303–313, 2007
Goldberg B, Britnell ES, Goldberg J: The relationship between engagement in meaningful activities and quality of life in persons disabled by mental illness. Occupational Therapy in Mental Health 18:17–44, 2002
Halford WK, Harrison C, Kalyansundaram V, et al.: Preliminary results from a psychoeducational program to rehabilitate chronic patients. Psychiatric Services 46:1189–1191, 1995
Leff J, Thornicroft G, Coxhead N, et al.: The TAPS project. 22: A five-year follow-up of long-stay psychiatric patients discharged to the community. British Journal of Psychiatry Supplement 25:13–17, 1994
Mairs H, Bradshaw T: Life skills training in schizophrenia. British Journal of Occupational Therapy 67:217–224, 2004
Thorup A, Petersen L, Jeppesen P, et al.: Integrated treatment ameliorates negative symptoms in first episode in psychosis-results form the Danish OPUS trial. Schizophrenia Research 79:95–105, 2005
Myin-Germeys I, Nicolson N, Delespaul P: The context of delusional experiences in the daily life of patients with schizophrenia. Psychological Medicine 31:489–498, 2001
Eklund M, Leufstadius C, Bejerholm U: Time use among people with psychiatric disabilities: Implications for practice. Psychiatric Rehabilitation Journal 32:177–191, 2009
Acknowledgements
The authors first wish to offer their most sincere gratitude to the 18 participants who accepted to share their moving journeys. Special thanks to Mrs. Mélanie Couture and Laurence Melançon for their precious input. Finally, we would like to acknowledge the Canadian Institutes of Health Research, Association des Hôpitaux de Jour en Psychiatrie du Québec, Réseau Québécois de la Recherche sur le Vieillissement, the Canadian Occupational Therapy Foundation and the Centre de recherche Fernand-Seguin for their financial support.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Larivière, N., Desrosiers, J., Tousignant, M. et al. Revisiting the Psychiatric Day Hospital Experience 6 Months After Discharge: How Was the Transition and What Have Clients Retained?. Psychiatr Q 81, 81–96 (2010). https://doi.org/10.1007/s11126-009-9119-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11126-009-9119-1