TY - JOUR
T1 - Early discharge in acute mental health
T2 - A rapid literature review
AU - Clibbens, Nicola
AU - Harrop, Deborah
AU - Blackett, Sally
N1 - Funding information:
The Burdett Trust for Nursing. Grant Number: BRN\SB\jll\101010662\169115
PY - 2018/10
Y1 - 2018/10
N2 - Long psychiatric hospital stays are unpopular with services users, harmful, andcostly. Economic pressures alongside a drive for recovery-orientated care in the least restrictivecontexts have led to increasing pressure to discharge people from hospital early. Hospital dischargeis, however, complex, stressful, and risky for service users and families. This rapid literature reviewaimed to assess what is known about early discharge in acute mental health. Searches wereconducted in nine bibliographic databases, reference lists, and targeted grey literature sources.Fourteen included papers focused on early discharge in mental health, a population over 18 yearswith a mental health condition, and reported outcomes on therapeutic care or service delivery.Quality appraisal was undertaken using The Mixed Method Appraisal Tool. The meta-summary ofthe literature found that early discharge was neither provided to all inpatients nor limited to theCrisis Resolution and Home Treatment (CRHT) service model internationally. Early dischargeinterventions required collaborative working and discharge planning. It was not associated withunplanned readmissions and had a small effect on length of stay. Most studies reported serviceoutcomes, whereas health outcomes were underreported. Professionals and service users werepositive about early discharge and service users asked for peer support. Carers preferred hospitalor day hospital care suggesting their need for respite. Limitations in the scope, detail, and qualityof the evidence about early discharge leave an unclear picture of the components of early dischargeas an intervention, its effectiveness, cost-effectiveness, or outcomes.
AB - Long psychiatric hospital stays are unpopular with services users, harmful, andcostly. Economic pressures alongside a drive for recovery-orientated care in the least restrictivecontexts have led to increasing pressure to discharge people from hospital early. Hospital dischargeis, however, complex, stressful, and risky for service users and families. This rapid literature reviewaimed to assess what is known about early discharge in acute mental health. Searches wereconducted in nine bibliographic databases, reference lists, and targeted grey literature sources.Fourteen included papers focused on early discharge in mental health, a population over 18 yearswith a mental health condition, and reported outcomes on therapeutic care or service delivery.Quality appraisal was undertaken using The Mixed Method Appraisal Tool. The meta-summary ofthe literature found that early discharge was neither provided to all inpatients nor limited to theCrisis Resolution and Home Treatment (CRHT) service model internationally. Early dischargeinterventions required collaborative working and discharge planning. It was not associated withunplanned readmissions and had a small effect on length of stay. Most studies reported serviceoutcomes, whereas health outcomes were underreported. Professionals and service users werepositive about early discharge and service users asked for peer support. Carers preferred hospitalor day hospital care suggesting their need for respite. Limitations in the scope, detail, and qualityof the evidence about early discharge leave an unclear picture of the components of early dischargeas an intervention, its effectiveness, cost-effectiveness, or outcomes.
KW - adult mental health
KW - literature review
KW - patient discharge
KW - psychiatric nursing
U2 - 10.1111/inm.12515
DO - 10.1111/inm.12515
M3 - Literature review
VL - 27
SP - 1305
EP - 1325
JO - International Journal of Mental Health Nursing
JF - International Journal of Mental Health Nursing
SN - 1445-8330
IS - 5
ER -