Patient perspectives on psychological interventions provided in adult psychiatric inpatient wards: A thematic synthesis

ObjectivesPsychological intervention is an important part of psychiatric inpatient treatment for people experiencing severe problems affecting their mental health. Unfortunately, many service users accessing acute inpatient services are not being offered psychological interventions. Recent research has focussed on effectiveness, facilitators and barriers to providing psychological interventions in this setting. This review aimed to provide a qualitative synthesis of service user perspectives regarding psychological interventions provided on inpatient wards, to understand what is helpful and unhelpful about current provision.MethodA systematic literature search of four databases was conducted to identify published qualitative literature regarding service user perspectives of NICE-recommended psychological interventions provided on adult acute mental health inpatient wards. Study quality was assessed using the Critical Appraisal Skills Programme tool. Data was analysed and synthesised using thematic analysis.ResultsThe search was completed in May 2023. Seventeen studies were included in the review and encapsulated feedback from at least 192 service users. All studies were rated as high or moderate on the quality appraisal tool. Three superordinate themes were identified: 'Connecting with Others', 'Psychological Processes' and 'Engaging with the Intervention'. Participants valued supportive relationships with peers and therapists and felt empowered to achieve change through expression, focussing on difficulties and gaining new perspectives. Participants wanted more support to maintain benefits and sometimes struggled to engage with group therapy due to difficult peer dynamics.ConclusionsThe results give a detailed synthesis of some of the important factors, from service users' perspectives, for accessing psychological interventions. Recommendations for clinical practice and future research are provided.