Abstract
Background
Care planning for recovery and to work towards hospital discharge is integral to good practice in mental health in-patient settings. Authorised leave from hospital, especially for those who are detained, can be used to check readiness for discharge and to maintain social connections that support a patient’s recovery journey. Leave therefore often involves friends and family, or ‘carers’. However, carer involvement in planning leave is limited, and carers struggle with feeling unsupported during the leave.
Aims
This study aimed to explore carers’ and mental health practitioners’ subjective experiences of leave in the context of implementing a set of practice guidelines for involving carers in planning and undertaking leave from hospital.
Method
Nine wards in six National Health Service trusts were recruited to implement the guidelines. Interviews were undertaken with carers (n = 6) and practitioners (n = 3) from these implementation wards and with carers (n = 7) from nine usual care wards. A further ten practitioners completed an anonymous online survey. Data were analysed thematically.
Results
Carers’ experiences on both implementation and usual care wards indicated variable levels of involvement, with carers positioned as partners in care, observers of care or outsiders to care. Practitioner perspectives highlighted practical, structural and conceptual challenges in working with carers, which precluded effective implementation of the guidelines.
Conclusions
The guidelines reflected what both carers and practitioners described as good practice, but resource limitations, unclear responsibilities and perceptions of carer roles limited engagement. Implementing approaches to working with carers in in-patient settings requires resourcing and clear role definition within staff–carer relationships.
Care planning for recovery and to work towards hospital discharge is integral to good practice in mental health in-patient settings. Authorised leave from hospital, especially for those who are detained, can be used to check readiness for discharge and to maintain social connections that support a patient’s recovery journey. Leave therefore often involves friends and family, or ‘carers’. However, carer involvement in planning leave is limited, and carers struggle with feeling unsupported during the leave.
Aims
This study aimed to explore carers’ and mental health practitioners’ subjective experiences of leave in the context of implementing a set of practice guidelines for involving carers in planning and undertaking leave from hospital.
Method
Nine wards in six National Health Service trusts were recruited to implement the guidelines. Interviews were undertaken with carers (n = 6) and practitioners (n = 3) from these implementation wards and with carers (n = 7) from nine usual care wards. A further ten practitioners completed an anonymous online survey. Data were analysed thematically.
Results
Carers’ experiences on both implementation and usual care wards indicated variable levels of involvement, with carers positioned as partners in care, observers of care or outsiders to care. Practitioner perspectives highlighted practical, structural and conceptual challenges in working with carers, which precluded effective implementation of the guidelines.
Conclusions
The guidelines reflected what both carers and practitioners described as good practice, but resource limitations, unclear responsibilities and perceptions of carer roles limited engagement. Implementing approaches to working with carers in in-patient settings requires resourcing and clear role definition within staff–carer relationships.
| Original language | English |
|---|---|
| Article number | e71 |
| Number of pages | 8 |
| Journal | BJPsych Open |
| Volume | 11 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 26 Mar 2025 |