Skip to main content

Advertisement

SpringerLink
Log in

Transition Experiences Following Psychiatric Hospitalization: A systematic Review of the Literature

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The period immediately following discharge after inpatient stay for mental illness has been found to be the time of greatest risk for adverse outcomes (e.g., rehospitalization, relapse, suicide). However, the experiences of patients as they transition from the hospital to the community are not well understood. The purpose of the present review was to systematically search and synthesize the literature examining the transition experiences of individuals following inpatient psychiatric stay. A systematic search was conducted for studies examining the experiences of patients as they transition back into their communities, using qualitative or quantitative methods. Qualitative articles were analyzed using thematic content analysis. Quantitative articles were extracted and summarized. The search identified 1614 abstracts, of which 27 (18 qualitative; 9 quantitative) were included in the review. The results of the analysis identified themes necessary for transition including safety, supported autonomy, and the opportunity to engage in a number of reintegration activities. A number of barriers were found that prevent integration, such as poverty, interpersonal difficulties, and stigma. The results highlight the disconnect that occurs for patients as they transition from hospital, pointing to the need for effective transitional interventions that target these challenges.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Bond, G. R., Drake, R. E., & Becker, D. R. (2008). An update on randomized controlled trials of evidence-based supported employment. Psychiatric Rehabilitation Journal, 31(4), 280.

    Article  PubMed  Google Scholar 

  • Burns, T., Catty, J., Dash, M., Roberts, C., Lockwood, A., & Marshall, M. (2007). Use of intensive case management to reduce time in hospital in people with severe mental illness: Systematic review and meta-regression. BMJ, 335(7615), 336.

    Article  PubMed  PubMed Central  Google Scholar 

  • Canadian Institute for Health Information and Statistics Canada. Health Indicators 2011. CIHI, 2011.

  • Caton, C. L., Koh, S. P., Fleiss, J. L., Barrow, S., & Goldstein, J. M. (1985). Rehospitalization in chronic schizophrenia. The Journal of Nervous and Mental Disease, 173(3), 139–148.

    Article  CAS  PubMed  Google Scholar 

  • Chernomas, W. M., Clarke, D. E., & Chisholm, F. A. (2000). Perspectives of women living with schizophrenia. Psychiatric Services, 51(12), 1517–1521.

    Article  CAS  PubMed  Google Scholar 

  • Chung, D. T., Ryan, C. J., Hadzi-Pavlovic, D., Singh, S. P., Stanton, C., & Large, M. M. (2017). Suicide rates after discharge from psychiatric facilities: A systematic review and meta-analysis. JAMA Psychiatry, 74(7), 694–702.

    Article  PubMed  PubMed Central  Google Scholar 

  • Coldwell, C. M., & Bender, W. S. (2007). The effectiveness of assertive community treatment for homeless populations with severe mental illness: A meta-analysis. American Journal of Psychiatry, 164(3), 393–399.

    Article  PubMed  Google Scholar 

  • Connerty, T. J., Roberts, R., & Williams, A. S. (2016). Managing life, motherhood and mental health after discharge from a mother–baby unit: An interpretive phenomenological analysis. Community Mental Health Journal, 52(8), 954–963.

    Article  PubMed  Google Scholar 

  • Corrigan, P. W., & Phelan, S. M. (2004). Social support and recovery in people with serious mental illnesses. Community Mental Health Journal, 40(6), 513–523.

    Article  PubMed  Google Scholar 

  • Davidson, L., Stayner, D. A., Lambert, S., Smith, P., & Sledge, W. H. (1997). Phenomenological and participatory research on schizophrenia: Recovering the person in theory and practice. Journal of Social Issues., 53(4), 767–784.

    Article  Google Scholar 

  • De Falco, M. L. (1975). The rehospitalization of discharged schizophrenic patients. Perspectives in Psychiatric Care, 13(3), 130–135.

    Article  CAS  PubMed  Google Scholar 

  • Draper, M. L., Stutes, D. S., Maples, N. J., & Velligan, D. I. (2009). Cognitive adaptation training for outpatients with schizophrenia. Journal of Clinical Psychology, 65(8), 842–853.

    Article  PubMed  Google Scholar 

  • Duhig, M., Gunasekara, I., & Patterson, S. (2017). Understanding readmission to psychiatric hospital in Australia from the service users’ perspective: A qualitative study. Health and Social Care in the Community, 25(1), 75–82.

    Article  PubMed  Google Scholar 

  • Gerson, L. D., & Rose, L. E. (2012). Needs of persons with serious mental illness following discharge from inpatient treatment: Patient and family views. Archives of Psychiatric Nursing, 26(4), 261–271.

    Article  PubMed  Google Scholar 

  • Gibson, R. W., D’Amico, M., Jaffe, L., & Arbesman, M. (2011). Occupational therapy interventions for recovery in the areas of community integration and normative life roles for adults with serious mental illness: A systematic review. American Journal of Occupational Therapy, 65(3), 247–256.

    Article  Google Scholar 

  • Harper, K., Stalker, C., Palmer, S., & Gadbois, S. (2005). Experiences of adults abused as children after discharge from inpatient treatment: Informal social support and self-care practices related to trauma recovery. Families in Society, 86(2), 217–225.

    Article  Google Scholar 

  • Harper, K., Stalker, C. A., Palmer, S., & Gadbois, S. (2008). Adults traumatized by child abuse: What survivors need from community-based mental health professionals. Journal of Mental Health, 17(4), 361–374.

    Article  Google Scholar 

  • Hawton, K., Sutton, L., Haw, C., Sinclair, J., & Deeks, J. J. (2005). Schizophrenia and suicide: Systematic review of risk factors. British Journal of Psychiatry, 187(1), 9–20.

    Article  Google Scholar 

  • Hebblethwaite, S., & Pedlar, A. (2005). Community integration for older adults with mental health issues: Implications for therapeutic recreation. Therapeutic Recreation Journal, 39, 4.

    Google Scholar 

  • Hendryx, M., Green, C. A., & Perrin, N. A. (2009). Social support, activities, and recovery from serious mental illness: STARS study findings. The Journal of Behavioral Health Services & Research, 36(3), 320–329.

    Article  Google Scholar 

  • Heron, J., Gilbert, N., Dolman, C., Shah, S., Beare, I., Dearden, S., et al. (2012). Information and support needs during recovery from postpartum psychosis. Archives of Women’s Mental Health, 15(3), 155–165.

    Article  PubMed  Google Scholar 

  • Herrera, E. G., Lifson, B. G., Hartmann, E., & Solomon, M. H. (1974). A 10-year follow-up of 55 hospitalized adolescents. American Journal of Psychiatry, 131(7), 769–774.

    Article  CAS  PubMed  Google Scholar 

  • Hodgins, S., Lincoln, T., & Mak, T. (2009). Experiences of victimisation and depression are associated with community functioning among men with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 44(6), 448–457.

    Article  PubMed  Google Scholar 

  • Hofer, A., Kemmler, G., Eder, U., Edlinger, M., Hummer, M., & Fleischhacker, W. W. (2004). Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. Journal of Clinical Psychiatry, 65(7), 932–939.

    Article  PubMed  Google Scholar 

  • Hor, K., & Taylor, M. (2010). Suicide and schizophrenia: a systematic review of rates and risk factors. Journal of Psychopharmacology, 24(4_suppl), 81–90.

    Article  PubMed  Google Scholar 

  • Johnston, E. R. (2013). A preliminary follow-up study of patients treated at an inpatient psychotherapy unit. South African Journal of Psychology., 43(3), 370–378.

    Article  Google Scholar 

  • Kidd, S. A., Virdee, G., Krupa, T., Burnham, D., Hemingway, D., Margolin, I., et al. (2013). The role of gender in housing for individuals with severe mental illness: a qualitative study of the Canadian service context. British Medical Journal Open, 3(6), e002914.

    Google Scholar 

  • Kidd, S. A., McKenzie, K. J., & Virdee, G. (2014). Mental health reform at a systems level: Widening the lens on recovery-oriented care. The Canadian Journal of Psychiatry., 59(5), 243–249.

    Article  PubMed  Google Scholar 

  • Kidd, S. A., Frederick, T., Tarasoff, L. A., Virdee, G., Lurie, S., Davidson, L., et al. (2016a). Locating community among people with schizophrenia living in a diverse urban environment. American Journal of Psychiatric Rehabilitation, 19(2), 103–121.

    Article  Google Scholar 

  • Kidd, S. A., Virdee, G., Mihalakakos, G., McKinney, C., Feingold, L., Collins, A., et al. (2016b). The welcome basket revisited: Testing the feasibility of a brief peer support intervention to facilitate transition from hospital to community. Psychiatric Rehabilitation Journal, 39(4), 335.

    Article  PubMed  Google Scholar 

  • Kirby, S. L., & McKenna, K. (1989). Experience, research, social change: Methods from the margins. Toronto: Garamond Press.

    Google Scholar 

  • Manuel, J. I., Hinterland, K., Conover, S., & Herman, D. B. (2012). “I hope I can make it out there”: Perceptions of women with severe mental illness on the transition from hospital to community. Community Mental Health Journal, 48(3), 302–308.

    Article  PubMed  Google Scholar 

  • McIntosh, J., & Worley, N. (1994). Beyond discharge: Telephone follow-up and aftercare. Journal of Psychosocial Nursing and Mental Health Services, 32(10), 21–27.

    CAS  PubMed  Google Scholar 

  • Mezzina, R., Borg, M., Marin, I., Sells, D., Topor, A., & Davidson, L. (2006). From participation to citizenship: How to regain a role, a status, and a life in the process of recovery. American Journal of Psychiatric Rehabilitation, 9, 39–61.

    Article  Google Scholar 

  • Mgutshini, T. (2010). Risk factors for psychiatric re-hospitalization: An exploration. International Journal of Mental Health Nursing, 19(4), 257–267.

    Article  PubMed  Google Scholar 

  • Miedema, B., & Stoppard, J. M. (1994). I just needed a rest’: Women’s experiences of psychiatric hospitalization. Feminism & Psychology, 4(2), 251–260.

    Article  Google Scholar 

  • Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6(7), e1000097.

    Article  Google Scholar 

  • Nelson, G., Sylvestre, J., Aubry, T., George, L., & Trainor, J. (2007). Housing choice and control, housing quality, and control over professional support as contributors to the subjective quality of life and community adaptation of people with severe mental illness. Administration and Policy in Mental Health and Mental Health, 34(2), 89–100.

    Article  Google Scholar 

  • Niimura, J., Tanoue, M., & Nakanishi, M. (2016). Challenges following discharge from acute psychiatric inpatient care in Japan: patients’ perspectives. Journal of Psychiatric and Mental Health Nursing, 23(9–10), 576–584.

    Article  CAS  PubMed  Google Scholar 

  • Nolan, P., Bradley, E., & Brimblecombe, N. (2011). Disengaging from acute inpatient psychiatric care: A description of service users’ experiences and views. Journal of Psychiatric and Mental Health Nursing, 18(4), 359–367.

    Article  CAS  PubMed  Google Scholar 

  • Olusina, A. K., & Ohaeri, J. U. (2003). Subjective quality of life of recently discharged Nigerian psychiatric patients. Social Psychiatry and Psychiatric Epidemiology, 38(12), 707–714.

    Article  PubMed  Google Scholar 

  • Prince, P., & Prince, C. (2002). Perceived stigma and community integration among clients of assertive community treatment. Psychiatric Rehabilitation Journal, 25, 323–331.

    Article  PubMed  Google Scholar 

  • Proctor, E., Morrow-Howell, N., Lee, M. J., Gledhill, J., & Blinne, W. (2006). Quality of care for depressed elders in post-acute care: Variations in needs met through services. The Journal of Behavioral Health Services & Research, 33(2), 127–141.

    Article  Google Scholar 

  • Redding, A., Maguire, N., Johnson, G., & Maguire, T. (2017). What is the lived experience of being discharged from a psychiatric inpatient stay? Community Mental Health Journal, 53(5), 568–577.

    Article  PubMed  Google Scholar 

  • Rouse, J., Mutschler, C., McShane, K., & Habal-Brosek, C. (2017). Qualitative participatory evaluation of a psychosocial rehabilitation program for individuals with severe mental illness. International Journal of Mental Health, 1, 1–18.

    Google Scholar 

  • Skärsäter, I., Dencker, K., Bergbom, I., Häggström, L., & Fridlund, B. (2003). Women’s conceptions of coping with major depression in daily life: A qualitative, salutogenic approach. Issues in Mental Health Nursing, 24(4), 419–439.

    Article  PubMed  Google Scholar 

  • Svensson, B., & Andersson, M. (2012). Involuntary discharge from medication-assisted treatment for people with heroin addiction–patients’ experiences and interpretations. Nordic Studies on Alcohol and Drugs, 29(2), 173–193.

    Article  Google Scholar 

  • Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8(1), 45.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tregoweth, J., Walton, J. A., & Reed, K. (2012). The experiences of people who re-enter the workforce following discharge from a forensic hospital. Journal of Vocational Rehabilitation, 37(1), 49–62.

    Google Scholar 

  • Vigod, S. N., Kurdyak, P. A., Dennis, C.-L., Leszcz, T., Taylor, V. H., Blumberger, D. M., et al. (2013). Transitional interventions to reduce early psychiatric readmissions in adults: Systematic review. British Journal of Psychiatry, 202(3), 187–194.

    Article  Google Scholar 

  • Wright, E. R., Gronfein, W. P., & Owens, T. J. (2000). Deinstitutionalization, social rejection, and the self-esteem of former mental patients. Journal of Health and Social Behavior, 1, 68–90.

    Article  Google Scholar 

  • Yanos, P. T., Barrow, S. M., & Tsemberis, S. (2004). Community integration in the early phase of housing among homeless persons diagnosed with severe mental illness: Successes and challenges. Community Mental Health Journal, 40(2), 133–150.

    Article  PubMed  Google Scholar 

  • Yanos, P. T., Felton, B. J., Tsemberis, S., & Frye, V. A. (2007). Exploring the role of housing type, neighborhood characteristics, and lifestyle factors in the community integration of formerly homeless persons diagnosed with mental illness. Journal of Mental Health, 16(6), 703–717. https://doi.org/10.1080/09638230701496378.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada

    Christina Mutschler

  2. Queens University, 99 University Ave, Kingston, ON, K7L 3N6, Canada

    Sidney Lichtenstein

  3. Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada

    Sean A. Kidd

  4. Program for Recovery and Community Health, Yale University, 319 Peck Street, New Haven, CT, 06513, USA

    Larry Davidson

Authors
  1. Christina Mutschler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sidney Lichtenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sean A. Kidd
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Larry Davidson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christina Mutschler.

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

Mutschler, C., Lichtenstein, S., Kidd, S.A. et al. Transition Experiences Following Psychiatric Hospitalization: A systematic Review of the Literature. Community Ment Health J 55, 1255–1274 (2019). https://doi.org/10.1007/s10597-019-00413-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-019-00413-9

Keywords

Search

Navigation