Advertisement

Community Mental Health Journal

, Volume 55, Issue 1, pp 129–136 | Cite as

Experiences of Mental Healthcare Reported by Individuals Diagnosed with Bipolar Disorder: An Italian Qualitative Study

  • Martine VallarinoEmail author
  • Filippo Rapisarda
  • Jan Scott
  • Tomaso Vecchi
  • Angelo Barbato
  • Barbara D’Avanzo
Original Paper
  • 83 Downloads

Abstract

This qualitative study explores experiences of mental health care by nine Italian users with a diagnosis of bipolar disorder. The findings from semi-structured interviews carried by professional researchers highlighted the following themes: mixed feelings about the diagnosis; lack of access to psychological interventions despite preferences of users; positive view of peer support, job as a safe haven, traumatic experiences of compulsory hospital admissions; need for crisis interventions as alternative to hospital admission. Most users’ views look in accordance with evidence-based recommendations seldom implemented in practice. Future research directions, implications of users’ expectations and experiences for service planning and quality improvement, are presented and discussed in the light of the qualitative available literature.

Keywords

Bipolar disorder Qualitative research Mental health care Psychosocial interventions Italy Users’ view 

Notes

Acknowledgements

We are indebted to the participants for sharing their experiences. We thank Cristian Camozzi for his work of transcription and Paolo Rigliano for his support to recruit the participants of the study.

Compliance with Ethical Standards

Conflict of interest

The authors declared no conflicts of interests with respect to the authorship and/or publication of this article.

Ethical Approval

Ethical approval were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Asad, S., & Chreim, S. (2016). Peer support providers’ role experiences on interprofessional mental health care teams: A qualitative study. Community Mental Health Journal, 52(7), 767–774.Google Scholar
  2. Attride-Stirling, J. (2001). Thematic networks: an analytic tool for qualitative research. Qualitative Research, 1(3), 385–405.Google Scholar
  3. Barbato, A., D’Avanzo, B., D’Anza, V., Montorfano, E., Savio, M., & Corbascio, C. G. (2014). Involvement of users and relatives in mental health service evaluation. Journal of Nervous and Mental Disease, 202(6), 479–486.Google Scholar
  4. Barbato, A., Vallarino, M., Rapisarda, F., Lora, A., Parabiaghi, A., D’Avanzo, B., & Lesage, A. (2016). Do people with bipolar disorders have access to psychosocial treatments? A survey in Italy. International Journal of Social Psychiatry, 62, 334–344.Google Scholar
  5. Biseul, I., Icick, R., Seguin, P., Bellivier, F., & Scott, J. (2016). Feasibility and acceptability of the ‘HABIT’ group programme for comorbid bipolar and alcohol and substance use disorders. Clinical Psychology & Psychotherapy.  https://doi.org/10.1002/cpp.2053.Google Scholar
  6. Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. Thousand Oaks: Sage.Google Scholar
  7. Cerimele, J. M., Chwastiak, L. A., Dodson, S., & Katon, W. J. (2014). The prevalence of bipolar disorder in general primary care samples: A systematic review. General Hospital Psychiatry, 36(1), 19–25.Google Scholar
  8. Colom, F., Vieta, E., Daban, C., Pacchiarotti, I., & Sanchez-Moreno, J. (2006). Clinical and therapeutic implications of predominant polarity in bipolar disorder. Journal of Affective Disorders, 93(1), 13–17.Google Scholar
  9. Cook, J. A., & Razzano, L. (2000). Vocational rehabilitation for persons with schizophrenia: Recent research and implications for practice. Schizophrenia Bulletin, 26, 87–103.Google Scholar
  10. Crowe, M., Inder, M., & Porter, R. (2015). Conducting qualitative research in mental health: Thematic and content analyses. Australian and New Zealand Journal of Psychiatry, 49, 616–623.Google Scholar
  11. Davison, J., & Scott, J. (2017). Should we intervene at stage 0? A qualitative study of youth who are asymptomatic, but at increased risk of developing bipolar disorders and parents with established disease. Early Intervention in Psychiatry.  https://doi.org/10.1111/eip.12421.Google Scholar
  12. Delmas, K., Proudfoot, J., Parker, G., & Manicavasagar, V. (2011). Recoding past experiences: A qualitative study of how patients and family members adjust to the diagnosis of bipolar disorder. Journal of Nervous and Mental Disease, 199(2), 136–139.Google Scholar
  13. Elgie, R., & Morselli, P. L. (2007). Social functioning in bipolar patients: The perception and perspective of patients, relatives and advocacy organizations—a review. Bipolar Disorders, 9, 144–157.Google Scholar
  14. Gilburt, H., Rose, D., & Slade, M. (2008). The importance of relationships in mental health care: A qualitative study of service users’ experiences of psychiatric hospital admission in the UK. BMC Health Services Research, 8(1), 92.Google Scholar
  15. Henry, C., Andreassen, O., Barbato, A., Demotes-Mainard, J., Goodwin, G., Leboyer, M., & Bauer, M. (2013). European network of bipolar research expert centre (ENBREC): A network to foster research and promote innovative care. International Journal of Bipolar Disorders, 1, 1–8.Google Scholar
  16. Inder, M. L., Crowe, M. T., Moor, S., Luty, S. E., Carter, J. D., & Joyce, P. R. (2008). “I actually don’t know who I am”: The impact of bipolar disorder on the development of self. Psychiatry, 71(2), 123–133.Google Scholar
  17. Jackson, Y., Kelland, J., Cosco, T. D., McNeil, D. C., & Reddon, J. R. (2009). Nonvocational outcomes of vocational rehabilitation: Reduction in health services utilization. Work, 33, 381–387.Google Scholar
  18. Joffe, H., & Yardley, L. (2004). Content and thematic analysis. In D. Marks & L. Yardley (Eds.), Research methods for clinical health psychology (pp. 56–68). California: Sage.Google Scholar
  19. Kallestad, H., Wullum, E., Scott, J., Stiles, T. C., & Morken, G. (2016). The long-term outcomes of an effectiveness trial of group versus individual psychoeducation for bipolar disorders. Journal of Affective Disorders, 15, 232–238.Google Scholar
  20. Lora, A., Conti, V., Leoni, O., & Rivolta, A. L. (2011). Adequacy of treatment for patients with schizophrenia spectrum disorders and affective disorders in Lombardy, Italy. Psychiatric Services, 62, 1079–1084.Google Scholar
  21. Mansell, W., Powell, S., Pedley, R., Thomas, N., & Jones, S. A. (2010). The process of recovery from bipolar I disorder: A qualitative analysis of personal accounts in relation to an integrative cognitive model. British Journal of Clinical Psychology, 49(2), 193–215.Google Scholar
  22. Matza, L. S., Rajagopalan, K. S., Thompson, C. L., & de Lissovoy, G. (2005). Misdiagnosed patients with bipolar disorder: Comorbidities, treatment patterns, and direct treatment costs. Journal of Clinical Psychiatry, 66(11), 1432–1440.Google Scholar
  23. Michalak, E. E., Yatham, L. N., Kolesar, S., & Lam, R. W. (2006). Bipolar disorder and quality of life: A patient-centered perspective. Quality of Life Research, 15(1), 25–37.Google Scholar
  24. Miklowitz, D. J., & Scott, J. (2009). Psychosocial treatments for bipolar disorder: Cost-effectiveness, mediating mechanisms, and future directions. Bipolar Disorders, 11, 110–122.Google Scholar
  25. National Institute for Health and Care Excellence (2011). Service user experience in adult mental health: Improving the experience of care for people using adult NHS mental health services. British Psychological Society. NICE Clinical Guideline 136. London.Google Scholar
  26. Perlick, D. A., Rosenheck, R. A., Clarkin, J. F., Sirey, J. A., Salahi, J., Struening, E. L., & Link, B. G. (2001). Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaptation of persons diagnosed with bipolar affective disorder. Psychiatric Services, 52(12), 1627–1632.Google Scholar
  27. Piat, M., Lesage, A., Boyer, R., Dorvil, H., Couture, A., Grenier, G., & Bloom, D. (2008). Housing for persons with serious mental illness: Consumer and service provider preferences. Psychiatric Services, 59, 1011–1017.Google Scholar
  28. Pompili, M., Harnic, D., Gonda, X., Forte, A., Dominici, G., Innamorati, M., … Girardi, P. (2014). Impact of living with bipolar patients: Making sense of caregivers’ burden. World Journal of Psychiatry, 4(1), 1–12.Google Scholar
  29. Pontin, E., Peters, S., Lobban, F., Rogers, A., & Morriss, R. K. (2009). Enhanced relapse prevention for bipolar disorder: A qualitative investigation of value perceived for service users and care coordinators. Implementation Science, 4, 4.Google Scholar
  30. Poole, R., Smith, D., & Simpson, S. (2015). Patients’ perspectives of the feasibility, acceptability and impact of a group-based psychoeducation programme for bipolar disorder: A qualitative analysis. BMC Psychiatry, 15, 16.Google Scholar
  31. Powell, T. J., Silk, K. R., & Albeck, J. H. (2000). Psychiatrists’ referrals to self-help groups for people with mood disorders. Psychiatric Services, 51, 809–811.Google Scholar
  32. Proudfoot, J. G., Parker, G. B., Benoit, M., Manicavasagar, V., Smith, M., & Gayed, A. (2009). What happens after diagnosis? Understanding the experiences of patients with newly diagnosed bipolar disorder. Health Expectations, 12(2), 120–129.Google Scholar
  33. Ridley, J., & Hunter, S. (2013). Subjective experiences of compulsory treatment from a qualitative study of early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003. Health and Social Care in the Community, 21(5), 509–518.Google Scholar
  34. Russell, S. J., & Browne, J. L. (2005). Staying well with bipolar disorder. Australian and New Zealand Journal of Psychiatry, 39(3), 187–193.Google Scholar
  35. Seal, K., Mansell, W., & Mannion, H. (2008). What lies between hypomania and bipolar disorder? A qualitative analysis of 12 non-treatment seeking people with a history of hypomanic experiences and no history of major depression. Psychology and Psychotherapy: Theory, Research and Practice, 81(1), 33–53.Google Scholar
  36. Skelly, N., Schnittger, R. I., Butterly, L., Frorath, C., Morgan, C., McLoughlin, D. M., & Fearon, P. (2013). Quality of care in psychosis and bipolar disorder from the service user perspective. Qualitative Health Research, 23(12), 1672–1685.Google Scholar
  37. Thornicroft, G., & Tansella, M. (2005). Growing recognition of the importance of service user involvement in mental health service planning and evaluation. Epidemiologia e Psichiatria Sociale, 14(1), 1–3.Google Scholar
  38. Trotter, R. T. (2012). Qualitative research sample design and sample size: Resolving and unresolved issues and inferential imperatives. Preventive Medicine, 55(5), 398–400.Google Scholar
  39. Vallarino, M., Henry, C., Etain, B., Gehue, L. J., Macneil, C., Scott, E. M. … Miklowitz, D. J. (2015). An evidence map of psychosocial interventions for the earliest stages of bipolar disorder. The Lancet Psychiatry, 2(6), 548–563.Google Scholar
  40. Veseth, M., Binder, P. E., Borg, M., & Davidson, L. (2012). Toward caring for oneself in a life of intense ups and downs: A reflexive-collaborative exploration of recovery in bipolar disorder. Qualitative Health Research, 22(1), 119–133.Google Scholar
  41. Veseth, M., Binder, P. E., Borg, M., & Davidson, L. (2013). How I found out I had a bipolar disorder: A reflexive-collaborative exploration of the process of identifying that one is struggling with a severe mental health problem. Qualitative Studies, 4(1), 21–38.Google Scholar
  42. Wallcraft, J. (2012). What has been learned from joint working between mental health professionals, patients and users of psychiatric services, their families and friends? Current Opinion in Psychiatry, 25, 317–321.Google Scholar
  43. Wheeler, C., Lloyd-Evans, B., Churchard, A., Fitzgerald, C., Fullarton, K., Mosse, L. … Johnson, S. (2015). Implementation of the Crisis Resolution Team model in adult mental health settings: A systematic review. BMC Psychiatry, 15(1), 74.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
  2. 2.Department of PsychologyUniversity of Milano-BicoccaMilanItaly
  3. 3.Academic Psychiatry, Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
  4. 4.Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and NeurosciencesKing’s College LondonLondonUK
  5. 5.Brain Connectivity CenterNational Neurological Institute C. MondinoPaviaItaly
  6. 6.IRCCS Istituto di Ricerche Farmacologiche Mario NegriMilanItaly

Personalised recommendations