BJSW Advance Access originally published online on August 15, 2005
British Journal of Social Work 2005 35(6):863-879; doi:10.1093/bjsw/bch222
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
On the Inside: A Narrative Review of Mental Health Inpatient Services
Jon Glasby is a Senior Lecturer at the Health Services Management Centre, University of Birmingham.
Helen Lester is a Reader in the Department of Primary Care, University of Birmingham.
Correspondence to Jon Glasby, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Edgbaston, Birmingham B15 2RT. E-mail: J.Glasby{at}bham.ac.uk
This paper describes and discusses the results of a narrative review of inpatient mental health services in the UK. Four main themes emerge from the review: the growing pressure on inpatient hospital services; the negative experience of inpatient services reported by many service users; the problematic nature of hospital discharge; and possible alternatives to hospital admission. This review also suggests that a failure to recognize and act on what appears to be happening in hospitals could result in inpatient care once again being subject to the scrutiny and criticism that cast a shadow over psychiatric services in the 1960s and 1970s. To stop this happening, current government policy is right to focus attention back onto acute care through new guidance and by commissioning research. However, changes also need to take place at a practice level so that front line workers are familiar with conditions in local acute services and can challenge unacceptable behaviour/services in support of their service users. With current changes in the make-up of local mental health services and a greater emphasis on partnership working between health and social care, it may be that social care practitioners can do this not only from the outside, but increasingly ‘on the inside’ (from within integrated health and social care organizations).
Keywords: Mental health, acute inpatient care, hospital admission, hospital discharge