Early discharge in acute mental health: A rapid literature review

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.