Service Users’ Experiences of Liaison Mental Health Care
Liaison mental health services provide mental health care, including assessment, interventions and sign posting to further specialist care, for those who present with mental health needs in non-mental health settings. Liaison mental health services in the United Kingdom most frequently exist within, but are not limited to general hospital provision. The commissioning of these services is however inconsistent, having developed in an ad hoc manner, and the evidence base for an appropriate structure remains limited. This thesis reports an extensive literature review which identifies that to date there has been no published detailed exploration of the experiences of service users of liaison mental health care. Only recently has research been published which tentatively identifies the ability of liaison mental health services to reduce costs to general hospitals of mental health presentations and co-morbidity. The empirical element of this programme of research is a study of the experiences of service users of a liaison mental health service, offered within a general hospital setting. The service users have experiences of both inpatient and emergency department care. The study utilises a secondary data analysis methodology to provide an in depth interpretation of these experiences. Data were analysed using a grounded theory constant comparative method. A core category of ‘negotiating and navigating the system’ emerged as service users’ experienced psychological distress as they attempted to manage their own resources and expectations as a personal safety net. It is only when this personal strategy fails to alleviate their symptoms that they attempt to find help from professional services within the general hospital. Gaining access to assessment by the liaison mental health service requires the service user to negotiate a complex system of care. This experience is represented in the study utilising a conceptual map of their journey, using the analogy of a road to explore the enablers and barriers to an effective experience of liaison mental health care. A model of liaison mental health care is required that ensures provision of educational support for non-mental health professionals within the general hospital setting. This education needs to acknowledge that those who are having their first experience of a mental health issue often do not know where else to seek help, other than the emergency department, because it represents the ‘front door’ of health care. The adoption of a comprehensive model of liaison mental health care is a priority for all general hospital settings in order to achieve improved service user experience, cost efficiency and integrated health care provision.
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