Improving patient experiences of mental health inpatient care: a randomised controlled trial

• DOI: 10.1017/s003329171700188x
• Publication Date: 2017-07-20T09:05:38Z
• Authors: T. Wykes; E. Csipke; P. Williams; L. Koeser; S. Nash; D. Rose; T. Craig; P. McCrone
• Keywords: Inpatient care

Background Poorer patient views of mental health inpatient treatment predict both further admissions and, for those admitted involuntarily, longer admissions. As advocated in the UK Francis report, we investigated hypothesis that improving staff training improves patients’ ward care. Method Cluster randomised trial with stepped wedge design 16 acute wards (using ralloc procedure Stata) by an independent statistician three waves to training. A psychologist trained on evidence-based group interventions and then supported their introduction each ward. The main outcome was blind self-report perceptions care (VOICE) before or up 2 years after between November 2008 January 2013. Results In total, 1108 inpatients took part (616 involuntarily under English Mental Health Act). On average 51.6 sessions were provided per Involuntary patient's of, satisfaction with, improved (N582, standardised effect −0·35, 95% CI −0·57 −0·12, p = 0·002; interaction value 0·006) but no benefit voluntarily (N469, −0.01, −0.23 0.22, 0.955) strong evidence overall (N1058, −0.18 s.d. , −0.38 0.01, 0.062). costs around £10 week. Resource allocation changed towards perceived meaningful contacts £12 (95% −£76 £98, 0.774). Conclusion Staff therapeutic environment least likely want admission, formally detained. This change might enhance future engagement all services prevent more costly