Understanding readmission to psychiatric hospital in Australia from the service users' perspective: a qualitative study

Duhig, Michael, Gunasekara, Imani and Patterson, Sue (2015) Understanding readmission to psychiatric hospital in Australia from the service users' perspective: a qualitative study. Health and Social Care in the Community, 1-8. doi:10.1111/hsc.12269

Author Duhig, Michael
Gunasekara, Imani
Patterson, Sue
Title Understanding readmission to psychiatric hospital in Australia from the service users' perspective: a qualitative study
Journal name Health and Social Care in the Community   Check publisher's open access policy
ISSN 1365-2524
Publication date 2015-08-19
Sub-type Article (original research)
DOI 10.1111/hsc.12269
Open Access Status Not Open Access
Start page 1
End page 8
Total pages 8
Place of publication Chichester, West Sussex, United Kingdom
Publisher Blackwell Publishing
Collection year 2016
Language eng
Abstract Inpatient care is integral to balanced mental health systems, contributing to containment of risk associated with psychiatric crises and affording opportunities for treatment. However, psychiatric wards are not always safe and service users are often dissatisfied with the experience. Hence, and because inpatient care is the most costly component of mental health systems, minimising duration of admission and reducing risk of readmission are clinical and strategic priorities internationally. With (primarily quantitative) research to date focused on explaining readmission in terms of characteristics of individuals and services, understanding of the ‘revolving door phenomenon’ remains limited. Considering verstehen critical to addressing this messy problem, we examined readmission from the service users’ perspective. Using grounded theory techniques, we inductively analysed data from interviews with 13 people readmitted to inpatient care within 28 days of discharge. Participants, including eight men, were recruited in 2013 from three psychiatric wards at a metropolitan hospital in Australia. Analysis supported description of readmission as a process, fundamentally related to insufficiency of internal, interpersonal and/or environmental resources to maintain community tenure. For the people in this study, admission to hospital was either the default coping mechanism or the culmination of counter-productive attempts to manage stressful circumstances. Readmission can appropriately be understood as one representation of a fundamental social malaise and the struggle of some people to survive in an apparently inhospitable world. The findings indicate that neither locating the ‘problem of readmission’ within an individual and promoting self-governance/self-control/self-regulation, nor identifying failures of specific services or sectors are likely to support the economic and ethical imperative of reducing psychiatric admissions. The findings of the study and limitations related to its conduct in a particular setting provide fertile ground for further research and design of interventions to break the readmission cycle. However, balanced, mental health services alone are insufficient; systems of care must become ‘recovery oriented’.
Keyword Experience
Mental health
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2016 Collection
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