Needs of Persons With Serious Mental Illness Following Discharge From Inpatient Treatment: Patient and Family Views

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Patients with serious mental illnesses often struggle with persistent symptoms that interfere with daily functioning in the community. The first days and weeks following inpatient treatment for an acute episode may be a critical time for patients to connect with the recommended community follow-up. Residual symptoms may interfere with their ability to access and benefit from these services to meet their needs. A descriptive study was conducted to explore perceptions of patients and families of patients' needs, functioning, coping and social support in the first 4 weeks after inpatient treatment. Results suggested that these patients had residual symptoms after discharge that interfered with functioning despite the availability of follow-up services. Patients identified unmet needs related to their illness. Family members identified concerns related to the lack of improvement in their ill relatives over time. Patients expressed satisfaction with care and felt supported by their families. Both patients and families seemed to lack a thorough understanding of goals for follow-up care.

Section snippets

Background

Severely mentally ill persons, diagnosed with schizophrenia or mood disorder, often experience a complex and disturbing illness course. Characterized by significant and sometimes disabling symptoms of delusions, hallucinations, social withdrawal, and amotivation, these patients are at high risk for relapse. Frequent relapse and rehospitalizations are major concerns, indicating a “downward spiral” of decreased functioning and increased dependence on others for care and support (U.S. Public

Design

This pilot study was designed to follow up a sample of recently discharged patients with SMI and document the extent of their ongoing illness-related needs. Open-ended interviews were used to assess patients' and families' perspectives of this aspect of transition to the community. Quantitative measures were used to describe the participants' functional status, coping, social support, illness-related needs, and satisfaction with care. The interviews were conducted to further explore the

Participants

Ten patients were enrolled in the study. They ranged in age from 23 to 81 years. All participants were African American. There were six men and four women. At baseline, patients were asked about their medications. Five patients were prescribed multiple medications, ranging from two to five medications. One patient was prescribed one medication, and four patients could not recall their medications. Three participants had one previous hospitalization; two had two previous hospitalizations, and

Discussion

Integration of the multiple sources of data from both patients and family members over a 4-week period enhanced the overall interpretation of the results of the needs assessment and evaluation of community adjustment after discharge. The presence of persistent illness-related symptoms in this small sample was not surprising, given that current psychiatric care relies on a comprehensive system of follow-up care for patients after inpatient treatment. The mean number of total needs of the

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