Skip to main content

Advertisement

Log in

From the (Dis)comfort of One’s Own Home: Patients’ Experiences of Hospitalization After Discharge. A Qualitative Study of Lived Experience of Hospitalization from the Perspective of People with a Mental Health Disorder

  • Original Article
  • Published:
Journal of Psychosocial Rehabilitation and Mental Health Aims and scope Submit manuscript

Abstract

The aim of the study was to investigate the role of inpatient treatment in the recovery process and explore how patients view hospitalization when looking back after 3 months. The study was developed within a framework of user-involved research; all stages of the research process involved cooperation with service user coresearchers. Fourteen patients were recruited, all of whom had been in inpatient treatment for at least 3 weeks. The findings are based on analyses of interviews with the participants 3 months after discharge. Three key themes reflected the participants’ experiences when looking back at their hospitalization 3 months after being discharged: (i) A break from everything “out there”; (ii) A safety net to catch me if I fall; and (iii) From being looked after to taking responsibility for yourself. The transition from being an inpatient to returning home can be hard. Findings suggest that belonging to a social network plays an important role in recovery, and that this might be a meaningful focus during admission.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Topor A, Andersson G, Bulow P, Stefansson CG, Denhov A. After the asylum? The new institutional landscape. Commun Ment Health J. 2016;52(6):731–7.

    Google Scholar 

  2. Cohen A, Minas H. Global mental health and psychiatric institutions in the 21st century. Epidemiol Psychiatr Sci. 2017;26(1):4–9.

    PubMed  Google Scholar 

  3. Slade M, Amering M, Farkas M, Hamilton B, O’Hagan M, Panther G, et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry. 2014;13(1):12–20.

    PubMed  PubMed Central  Google Scholar 

  4. Deegan PE. Recovery: the lived experience of rehabilitation. Psychosoc Rehabil J. 1988;11(4):11–9.

    Google Scholar 

  5. Law H, Shryane N, Bentall RP, Morrison AP. Longitudinal predictors of subjective recovery in psychosis. Br J Psychiatry. 2016;209(1):48–53.

    PubMed  Google Scholar 

  6. Smith Y, Spitzmueller MC. Worker perspectives on contemporary milieu therapy: a cross-site ethnographic study. Soc Work Res. 2016;40(2):105–16.

    PubMed  PubMed Central  Google Scholar 

  7. Thomas SP, Shattell M, Martin T. What’s therapeutic about the therapeutic milieu? Arch Psychiatr Nurs. 2002;16(3):99–107.

    PubMed  Google Scholar 

  8. Staniszewska S, Mockford C, Chadburn G, Fenton SJ, Bhui K, Larkin M, et al. Experiences of in-patient mental health services: systematic review. Br J Psychiatry. 2019;214:329–38.

    PubMed  Google Scholar 

  9. Shattell MM, Starr SS, Thomas SP. ‘Take my hand, help me out’: mental health service recipients’ experience of the therapeutic relationship. Int J Ment Health Nurs. 2007;16(4):274–84.

    PubMed  Google Scholar 

  10. Wiechula R, Conroy T, Kitson AL, Marshall RJ, Whitaker N, Rasmussen P. Umbrella review of the evidence: what factors influence the caring relationship between a nurse and patient? J Adv Nurs. 2016;72(4):723–34.

    PubMed  Google Scholar 

  11. Cleary M, Hunt GE, Horsfall J, Deacon M. Nurse-patient interaction in acute adult inpatient mental health units: a review and synthesis of qualitative studies. Issues Ment Health Nurs. 2012;33(2):66–79.

    PubMed  Google Scholar 

  12. Newman D, O’Reilly P, Lee SH, Kennedy C. Mental health service users’ experiences of mental health care: an integrative literature review. J Psychiatr Ment Health Nurs. 2015;22(3):171–82.

    PubMed  Google Scholar 

  13. Davidson L, Carr E, Bellamy C, Tondora J, Fossey E, Styron T, et al. Principles for recovery-oriented inpatient care. In: Singh NN, Barber JW, Van Sant S, editors. Handbook of recovery in inpatient psychiatry. Evidence-based practices in behavioral health. Cham: Springer; 2016. p. 39–58.

    Google Scholar 

  14. Eldal K, Natvik E, Veseth M, Davidson L, Skjolberg A, Gytri D, et al. Being recognised as a whole person: a qualitative study of inpatient experience in mental health. Issues Ment Health Nurs. 2019;40(2):88–96.

    PubMed  Google Scholar 

  15. Rise MB, Westerlund H, Bjorgen D, Steinsbekk A. Safely cared for or empowered in mental health care? Yes, please. Int J Soc Psychiatry. 2014;60(2):134–8.

    PubMed  Google Scholar 

  16. Eldal K, Veseth M, Natvik E, Davidson L, Skjolberg A, Gytri D, et al. Contradictory experiences of safety and shame in inpatient mental health practice—a qualitative study. Scand J Caring Sci. 2019;0:0.

    Google Scholar 

  17. Davidson L, Stayner DA, Lambert S, Smith P, Sledge WH. Phenomenological and participatory research on schizophrenia: recovering the person in theory and practice. J Soc Issues. 1997;53(4):767–84.

    Google Scholar 

  18. Davidson L, Shahar G, Stayner DA, Chinman MJ, Rakfeldt J, Tebes JK. Supported socialization for people with psychiatric disabilities: lessons from a randomized controlled trial. J Commun Psychol. 2004;32(4):453–77.

    Google Scholar 

  19. Davidson L. Habits and other anchors of everyday life that people with psychiatric disabilities may not take for granted. OTJR Occup Particip Health. 2016;27(1_suppl):60S–8S.

    Google Scholar 

  20. Tew J, Ramon S, Slade M, Bird V, Melton J, Le Boutillier C. Social factors and recovery from mental health difficulties: a review of the evidence. Br J Soc Work. 2012;42(3):443–60.

    Google Scholar 

  21. Hasson-Ohayon I, Lerer G, Tuval-Mashiach R, Shamir E, Roe D. Having someone waiting for you outside: transitions from psychiatric hospitalization to the community. Psychosis. 2016;8(3):250–9.

    Google Scholar 

  22. Meltzer H, Bebbington P, Dennis MS, Jenkins R, McManus S, Brugha TS. Feelings of loneliness among adults with mental disorder. Soc Psychiatry Psychiatr Epidemiol. 2013;48(1):5–13.

    PubMed  Google Scholar 

  23. Beutel ME, Klein EM, Brahler E, Reiner I, Junger C, Michal M, et al. Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry. 2017;17(1):97.

    PubMed  PubMed Central  Google Scholar 

  24. Granerud A, Severinsson E. The struggle for social integration in the community—the experiences of people with mental health problems. J Psychiatr Ment Health Nurs. 2006;13(3):288–93.

    PubMed  Google Scholar 

  25. Davidson L, Shaw J, Welborn S, Mahon B, Sirota M, Gilbo P, et al. “I don’t know how to find my way in the world”: contributions of user-led research to transforming mental health practice. Psychiatry. 2010;73(2):101–13.

    PubMed  Google Scholar 

  26. Moltu C, Stefansen J, Svisdahl M, Veseth M. Negotiating the coresearcher mandate—service users’ experiences of doing collaborative research on mental health. Disabil Rehabil. 2012;34(19):1608–16.

    PubMed  Google Scholar 

  27. Veseth M, Binder PE, Borg M, Davidson L. Collaborating to stay open and aware: service user involvement in mental health research as an aid in reflexivity. Nordic Psychol. 2017;69(4):256–63.

    Google Scholar 

  28. Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: theory, method and research. London: Sage; 2009.

    Google Scholar 

  29. Smith JA. Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qual Res Psychol. 2004;1(1):39–54.

    Google Scholar 

  30. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.

    Google Scholar 

  31. Braun V, Clarke V, Hayfield N, Terry G. Thematic analysis. In: Liamputtong P, editor. Handbook of research methods in health social sciences. Singapore: Springer Singapore; 2019. p. 843–60.

    Google Scholar 

  32. Telford R, Faulkner A. Learning about service user involvement in mental health research. J Ment Health. 2009;13(6):549–59.

    Google Scholar 

  33. Kvale S, Brinkmann S. Interviews: learning the craft of qualitative research interviewing. London: Sage; 2009.

    Google Scholar 

  34. Malterud K. Kvalitative Forskingsmetoder for medisin og helsefag. 4th ed. Oslo: Universitetsforlaget; 2017. p. 251.

    Google Scholar 

  35. Staley K, Barron D. Learning as an outcome of involvement in research: what are the implications for practice, reporting and evaluation? Res Involv Engagem. 2019;5(1):14.

    PubMed  PubMed Central  Google Scholar 

  36. Locock L, Kirkpatrick S, Brading L, Sturmey G, Cornwell J, Churchill N, et al. Involving service users in the qualitative analysis of patient narratives to support healthcare quality improvement. Res Involv Engagem. 2019;5(1):1.

    PubMed  PubMed Central  Google Scholar 

  37. Goffman E. Asylums: essays on the social situation of mental patients and other inmates. London: Routledge; 2017.

    Google Scholar 

  38. Franczak M, Barshter D, Reich JW, Kent M, Zautra AJ. Enhancing resilience and sustaining recovery. In: Singh NN, Barber JW, Van Sant S, editors. Handbook of recovery in inpatient psychiatry. Evidence-based practices in behavioral health. Cham: Springer; 2016. p. 409–38.

    Google Scholar 

  39. Borg M, Davidson L. The nature of recovery as lived in everyday experience. J Ment Health. 2008;17(2):129–40.

    Google Scholar 

  40. Topor A, Andersson G, Denhov A, Holmqvist MS, Mattsson M, Stefansson CG, et al. Psychosis and poverty: coping with poverty and severe mental illness in everyday life. Psychosis-Psychol Soc Integr Approach. 2014;6(2):117–27.

    Google Scholar 

  41. Topor A, Di Girolamo S. “You have to be careful who you talk to and what you say…”—on psychosis and making rational choices. J Ment Health (Abingdon, England). 2010;19(6):553–61.

    Google Scholar 

  42. Roos E, Bjerkeset O, Sondenaa E, Antonsen DO, Steinsbekk A. A qualitative study of how people with severe mental illness experience living in sheltered housing with a private fully equipped apartment. BMC Psychiatry. 2016;16(1):186.

    PubMed  PubMed Central  Google Scholar 

  43. Davidson L, Haglund KE, Stayner DA, Rakfeldt J, Chinman MJ, Kraemer Tebes J. “It was just realizing…that life isn’t one big horror”: a qualitative study of supported socialization. Psychiatr Rehabil J. 2001;24(3):275–92.

    PubMed  Google Scholar 

  44. Townley G. “It helps you not feel so bad—feel like you again”: the importance of community for individuals with psychiatric disabilities. J Psychosoc Rehabil Ment Health. 2015;2(2):113–24.

    Google Scholar 

  45. Geller J, Janson P, McGovern E, Valdini A. Loneliness as a predictor of hospital emergency department use. J Fam Pract. 1999;10:801.

    Google Scholar 

  46. Topor A, Borg M, Di Girolamo S, Davidson L. Not just an individual journey: social aspects of recovery. Int J Soc Psychiatry. 2011;57(1):90–9.

    PubMed  Google Scholar 

  47. Bjornestad J, Joa I, Larsen TK, Langeveld J, Davidson L, Ten Velden Hegelstad W, et al. “Everyone needs a friend sometimes”—social predictors of long-term remission in first episode psychosis. Front Psychol. 2016;7(1491):1491.

    PubMed  PubMed Central  Google Scholar 

  48. Veseth M, Binder PE, Stige SH. “If there’s no stability around them”: experienced therapists’ view on the role of patients’ social world in recovery in bipolar disorder. Int J Ment Health Syst. 2017;11(1):55.

    PubMed  PubMed Central  Google Scholar 

  49. Tanaka K, Davidson L. The challenge of social inclusion: a basis for enclave community approaches. J Psychosoc Rehabil Ment Health. 2017;4(2):189–204.

    Google Scholar 

  50. Nurser KP, Rushworth I, Shakespeare T, Williams D. Personal storytelling in mental health recovery. Ment Health Rev J. 2018;23(1):25–36.

    Google Scholar 

  51. Seikkula J, Olson ME. The open dialogue approach to acute psychosis: its poetics and micropolitics. Fam Process. 2003;42(3):403–18.

    PubMed  Google Scholar 

  52. Vuokila-Oikkonen P, Janhonen S, Nikkonen M. Patient initiatives in psychiatric care concerning shame in the discussion in co-operative team meetings. J Psychiatr Ment Health Nurs. 2002;9(1):23–32.

    PubMed  Google Scholar 

  53. Biringer E, Davidson L, Sundfor B, Ruud T, Borg M. Experiences of support in working toward personal recovery goals: a collaborative, qualitative study. BMC Psychiatry. 2016;16(1):426.

    PubMed  PubMed Central  Google Scholar 

  54. Happell B, Gordon S, Bocking J, Ellis P, Roper C, Liggins J, et al. Mental health researchers’ views about service user research: a literature review. Issues Ment Health Nurs. 2018;39(12):1010–6.

    PubMed  Google Scholar 

  55. Alvesson MS, Kaj S. Reflexive methodology: new vistas for qualitative research. London: Sage; 2000.

    Google Scholar 

  56. Finlay L, Gough B. Reflexivity: a practical guide for researchers in health and social sciences. Oxford: Blackwell Science; 2003.

    Google Scholar 

  57. Finlay L, Molano-Fisher P. ‘Transforming’ self and world: a phenomenological study of a changing lifeworld following a cochlear implant. Med Health Care Philos. 2008;11(3):255–67.

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the patients who participated in the study and the staff at the three different mental health clinics who gave us access to the ward. We are grateful to the co-researcher group for bringing a deeper understanding to the phenomenon. In this project, the co-researcher methodology strengthen the project.

Funding

Department of Health and Care Sciences, Western Norway University of Applied Sciences, Førde.

Author information

Authors and Affiliations

Authors

Contributions

LD was not a part of the core research team, provided scientific advice in designing and conducting the study, including manuscript preparation. EN, MV and CM were involved in analysis and manuscript preparation. KE contributed to all phases of the study. We confirm that all authors listed meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors, and all authors are in agreement with the manuscript.

Corresponding author

Correspondence to Kari Eldal.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The Regional Committee for Medical and Health Research Ethics approved the study (2016/30 REKvest).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eldal, K., Natvik, E., Veseth, M. et al. From the (Dis)comfort of One’s Own Home: Patients’ Experiences of Hospitalization After Discharge. A Qualitative Study of Lived Experience of Hospitalization from the Perspective of People with a Mental Health Disorder. J. Psychosoc. Rehabil. Ment. Health 6, 187–198 (2019). https://doi.org/10.1007/s40737-019-00143-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40737-019-00143-x

Keywords

Navigation