There and back again: staff and service user perspectives on readmission to a secure mental health hospital

Abstract

Purpose Readmission to hospital can be distressing, costly for the National Health Service (NHS) and legally it should be a last resort as it entails restriction of liberty. This study aims to develop an understanding of factors leading to readmission for a cohort of service users under the care of a community forensic mental health team (CFMHT) in England to consider how support could be improved to reduce incidence of future readmissions. Design/methodology/approach Thematic analysis was used to examine case recording relating to 13 service users who were readmitted to hospital within a specified time period. The same service users were invited to complete questionnaires regarding their views of what contributed to the readmission to cross-reference with themes identified. Findings The analysis of case notes produced eight sub-themes. These were sorted into three overarching themes, illustrating the challenges that service users face upon discharge from hospital, the sense they make of these challenges and the impact upon relational patterns, in particular with the CFMHT. Researchers highlight that the multiple challenges can increase service users’ sense of being under threat which can lead to distrust of professionals. Practical implications Practical suggestions arising from the study were fed back to the subject team and are listed at the end of the paper. Originality/value Findings from this study parallel those previously reported. This study contributes an inter-relational aspect of the factors and the central role of meaning-making in the path of recovery and building a life in the community.