Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis
Abstract Background The transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of ca...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-019-4658-0 |
| _version_ | 1828841726038507520 |
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| author | Natasha Tyler Nicola Wright Justin Waring |
| author_facet | Natasha Tyler Nicola Wright Justin Waring |
| author_sort | Natasha Tyler |
| collection | DOAJ |
| description | Abstract Background The transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in these transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve. Methods The study aimed to identify the evidence base for interventions to support continuity of care and safety in the transition from acute mental health inpatient to community services at the point of discharge. Electronic Databases including PsycINFO, MEDLINE, Embase, HMIC, CINAHL, IBSS, Cochrane Library Trials, ASSIA, Web of Science and Scopus, were searched between 2000 and May 2018. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions relating to discharge from the acute ward to the community. The results were analysed using a narrative synthesis technique. Results The total number of papers from which data were extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model), others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis. Conclusions The interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting. |
| first_indexed | 2024-12-12T20:10:10Z |
| format | Article |
| id | doaj.art-022112da9ccc47d39683fe7af2764641 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-12T20:10:10Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-022112da9ccc47d39683fe7af27646412022-12-22T00:13:32ZengBMCBMC Health Services Research1472-69632019-11-0119112410.1186/s12913-019-4658-0Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesisNatasha Tyler0Nicola Wright1Justin Waring2NIHR Greater Manchester Patient Safety Translational Research Centre, The University of ManchesterSchool of Health Sciences, University of NottinghamNIHR Greater Manchester Patient Safety Translational Research Centre, The University of ManchesterAbstract Background The transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in these transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve. Methods The study aimed to identify the evidence base for interventions to support continuity of care and safety in the transition from acute mental health inpatient to community services at the point of discharge. Electronic Databases including PsycINFO, MEDLINE, Embase, HMIC, CINAHL, IBSS, Cochrane Library Trials, ASSIA, Web of Science and Scopus, were searched between 2000 and May 2018. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions relating to discharge from the acute ward to the community. The results were analysed using a narrative synthesis technique. Results The total number of papers from which data were extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model), others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis. Conclusions The interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting.http://link.springer.com/article/10.1186/s12913-019-4658-0Systematic reviewCare transitionsMental healthInterventionsDischargeAcute services |
| spellingShingle | Natasha Tyler Nicola Wright Justin Waring Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis BMC Health Services Research Systematic review Care transitions Mental health Interventions Discharge Acute services |
| title | Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis |
| title_full | Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis |
| title_fullStr | Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis |
| title_full_unstemmed | Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis |
| title_short | Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis |
| title_sort | interventions to improve discharge from acute adult mental health inpatient care to the community systematic review and narrative synthesis |
| topic | Systematic review Care transitions Mental health Interventions Discharge Acute services |
| url | http://link.springer.com/article/10.1186/s12913-019-4658-0 |
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