‘They all said you could come and speak to us’: patients’ expectations and experiences of help on an acute psychiatric inpatient ward

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  Acute psychiatric inpatient care (acute care) is a part of the mental health care continuum. People are admitted to acute care when they are not able to be treated safely in the community.
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  Interviews with 13 people who had been patients on an acute ward highlighted their expectation that they would receive help through talking with the nurses while on the ward.
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  Participants were expected to ask for help from the nurses who said they could come and talk. They perceived that the nurses were always too busy to talk. Many of the tasks that the nurses were observed doing were perceived as ‘non-nursing’ tasks.
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  Participants supported each other because they didn’t feel they were getting the help they needed from the nurses. While some participants reported this as helpful, others found it added to their emotional burden.

Acute psychiatric inpatient care forms an integral part of mental health services. Few studies have focussed on the patient experience of acute care. Research into patient experience is increasingly important to policy and service development processes. Knowledge of patient experiences facilitates the development of nursing practice. The aim of the study was to gain insight into the experience of being a patient on an acute inpatient psychiatric ward. Thirteen participants were recruited from the acute ward. Unstructured interviews were used to gather narrative data of their experiences. Holistic analysis of the narratives was informed by Gee’s socio-linguistic theories that meaning is linked to narrative structure. Reading of the holistic analyses yielded themes of help, safety and power running across the participants’ experiences. The patient experience was characterized by dissonance between expectation and experience, the search for a nurse–patient relationship and the development of strategies to cope with being on the acute ward. This paper focuses on the theme of ‘Help’ where participants describe their expectation that they will receive help through the development of relationships with the nurses, and their experience of the barriers to this. In response, participants developed strategies to support each other.