Gill, F; (2014) The transition from adolescent inpatient care back to the community: Young people’s perspectives. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Whilst the majority of adolescents receive support from mental health services in community settings, some have problems that reach a level of severity and complexity that requires admission to hospital. Little is known, however, about how the young person adjusts and reintegrates back home following discharge from an inpatient unit. Part 1 is a literature review evaluating the evidence-base of alternative provisions to inpatient care for children and young people with severe and complex mental health problems. A total of 13 studies were identified for inclusion, and five intervention types were classified. The majority of the studies reported positive outcomes, but the strength of their designs varied. Overall, the studies provided promising findings for the effectiveness of community-based interventions for children and adolescents with complex mental health needs. Part 2 is a qualitative study that explored adolescent inpatients’ anticipations about the transition from inpatient care back into the community, that was informed by Self Determination Theory (Deci & Ryan, 1980). Semi-structured interviews were conducted with 12 adolescent inpatients and transcripts were analysed using thematic analysis. The adolescents saw the transition back home as providing both opportunities (e.g. personal growth) and challenges (e.g. re-entering the “real world” and negative perceptions from others). Part 3 is a reflective discussion of the process of developing and carrying out the qualitative study. It focuses on three areas: issues of self-reflexivity, the process of interviewing adolescents, and the tensions of balancing a phenomenological approach whilst being informed by a theoretical framework.

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