Discharge planning for the mentally disabled

Discharge planning in mental health care: an integrative review of the literature

AIMS AND OBJECTIVES

To identify the evidence base related to discharge planning in the context of acute and community mental healthcare service provision to ascertain the need for future research.

BACKGROUND

Discharge planning is an important activity when preparing consumers to transition from hospital to home. The efficiency of discharge planning for consumers living with a mental health issue can influence both the number of future readmissions to acute-care facilities and their quality of life at home.

DESIGN

An integrative review of the peer-reviewed literature.

METHOD

This review uses specific search terms and a 21-year time frame to search two key nursing databases CINAHL (Cinahl Information Systems, Glendale, CA, USA) and PSYCHINFO (American Psychological Association, Washington, DC, USA) for research reports investigating the substantive area of enquiry. Hand searches of reference lists and author searches were also conducted. Nineteen peer-reviewed journal articles met the inclusion criteria for this review.

RESULTS

Research findings about discharge planning for people living with a mental health issue identify the importance of communication between health professionals, consumers and their families to maximise the effectiveness of this process. The complexity of consumer's healthcare needs influences the discharge planning process and impacts on aftercare compliance and readmission rates. There is a limited amount of research findings relating to differences between health professionals and families' perceptions of the level of information required for effective discharge planning, and the appropriate level of involvement of individuals living with a mental health issue in their own discharge planning. Results from this integrative review will inform future research related to this topic.

CONCLUSION

Discharge planning for consumers living with a mental health issue involves many stakeholders who have different expectations regarding the type of information required and the necessary level of involvement of people living with a mental health issue in this process.

RELEVANCE TO CLINICAL PRACTICE

Comprehensive discharge planning can result in reduced readmissions to both acute and community mental health services. Understanding the impact of effective communication on the outcomes of discharge planning is an important step in promoting success.

Self-care actions of chronic schizophrenics associated with meeting solitude and social interaction requisites

Solitude becomes a way of life and social interaction a scarce commodity for many chronic schizophrenics who are in institutional settings. This article describes the self-care actions associated with meeting solitude and social interaction requisites as reported by 10 institutionalized chronic schizophrenics. Eighteen solitude self-care actions and 10 social interaction self-care actions emerged from the interview data. The solitude self-care actions clustered around two distinct categories: distancing and organizing. The social interaction self-care actions clustered around one category, managing situations. The implications of this study extend to anyone who is in the position of providing care and support to an individual diagnosed as a chronic schizophrenic. Additional research is suggested to increase the generalizability of the findings of this study and to isolate conditions related to Orem's (1985) sets of actions for maintenance of a balance between solitude and social interaction.