Beyond satisfaction, what service users expect of inpatient mental health care: A literature review

Accessible summary Inpatient care is a necessary part of the care continuum for some mental health service users. This inpatient care is increasingly burdened by fewer beds, shorter lengths of stay and fewer resources. Service users expect to have a safe environment in which to receive mental health treatment. They emphasize the expectation that this treatment will involve developing relationships with nurses and other staff. They expect their inpatient care to provide one-on-one counselling, self-help groups, educational sessions, informal opportunities for communication with knowledgeable and empathetic staff, and discharge planning. If nurses are to meet these expectations, attention will need to be given to: providing nursing students with opportunities to practice individual counseling; creating a welcoming environment for new nurses to inspire them to select mental health nursing as their specialty and to encourage them to remain in the field; limiting the number of patients assigned to each nurse; and refocusing nurses away from office work and administrative duties and towards more contact with patients. Abstract To provide efficient and effective inpatient mental health services, it is imperative to not only ascertain if service users are satisfied with the care received from nurses, but also the degree to which initial expectations are being met. Ten reports of primary research on service users' experiences, perceptions and expectations of inpatient mental health care were examined to understand what service users' expect of inpatient mental health care and the implications for nursing practice. The World Health Organization's description of responsiveness to service users' non-medical expectations of care was used as a framework for retrieving literature and organizing the research outcomes. Responsiveness includes seven categories of healthcare performance ranging from respect for the dignity of the person, to adequacy of amenities, and choice of provider. Service users expect to form interpersonal relationships with nurses; however, non-clinical responsibilities serve as barriers which consume considerable available nursing time that otherwise could be spent developing therapeutic relationships. In addition, inpatient programming ideas are identified for the provision of better services. Hospitals' expectations of mental health nurses will need to be reconsidered if these nurses are to provide the time and resources necessary to meet current service users' expectations.