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Patients' experiences of assessment and detention under mental health legislation: systematic review and qualitative meta-synthesis

Akther, SF; Molyneaux, E; Stuart, R; Johnson, S; Simpson, A; Oram, S; (2019) Patients' experiences of assessment and detention under mental health legislation: systematic review and qualitative meta-synthesis. BJPsych Open , 5 (3) , Article e37. 10.1192/bjo.2019.19. Green open access

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Abstract

Background Understanding patient experiences of detention under mental health legislation is crucial to efforts to reform policy and practice. Aims To synthesise qualitative evidence on patients' experiences of assessment and detention under mental health legislation. Method Five bibliographic databases were searched, supplemented by reference list screening and citation tracking. Studies were included if they reported on patient experiences of assessment or detention under mental health legislation; reported on patients aged 18 years or older; collected data using qualitative methods; and were reported in peer-reviewed journals. Findings were analysed and synthesised using thematic synthesis. Results The review included 56 papers. Themes were generally consistent across studies and related to information and involvement in care, the environment and relationships with staff, as well as the impact of detention on feelings of self-worth and emotional state. The emotional impact of detention and views of its appropriateness varied, but a frequent theme was fear and distress during detention, including in relation to the use of force and restraint. Where staff were perceived as striving to form caring and collaborative relationships with patients despite the coercive nature of treatment, and when clear information was delivered, the negative impact of involuntary care seemed to be reduced. Conclusions Findings suggest that involuntary in-patient care is often frightening and distressing, but certain factors were identified that can help reduce negative experiences. Coproduction models may be fruitful in developing new ways of working on in-patient wards that provide more voice to patients and staff, and physical and social environments that are more conducive to recovery.

Type: Article
Title: Patients' experiences of assessment and detention under mental health legislation: systematic review and qualitative meta-synthesis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1192/bjo.2019.19
Publisher version: https://doi.org/10.1192/bjo.2019.19
Language: English
Additional information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (http://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Systematic review; meta-synthesis; qualitative; mental health legislation; involuntary admission.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10082856
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