Transitional discharge model for community mental health integration: A focused ethnographic study of clients’ perspectives

• Published in: International journal of mental health nursing 2021-04, Vol.30 (2), p.553-562
• Main Authors: Forchuk, Cheryl, Gyamfi, Sebastian, Martin, Mary‐Lou, Corring, Deborah, Srivastava, Rani, Harerimana, Boniface
• Format: Article
• Language: English
• Subjects: Clients; community integration; Community mental health services; Community resources; Connectedness; Continuity of care; Discharge; Ethnography; Focus groups; focused ethnography; Friendship; Hospitalization; Hospitals; Integrated care; Intervention; Mental disorders; Mental health; Mental health care; mental illness; Nursing; Perceptions; Qualitative research; Reassurance; Recovery; Social support; Stigma; Supporters; transition discharge model
• ISSN: 1445-8330; 1447-0349
• DOI: 10.1111/inm.12821

Clients' perceptions of continuous support during the transition from hospital to the community have been understudied. The present study evaluated clients' perceptions of the benefits and potential adjustments to the implementation of a transitional discharge model (TDM), an intervention for community integration of clients with mental health issues. A focused ethnography methodology was used to investigate the effectiveness of the TDM. Data were collected using two sets of focus groups which involved 87 clients with mental illness seeking care from nine hospitals across the Province of Ontario, Canada. One focus group was conducted at six months and another at the one‐year time point of the study. Data analysis followed a four‐step ethnographic approach proposed by Leininger (1985) for thematic analysis in qualitative research. Four main themes emerged: (i) clients' perceived benefits of the TDM. These came in the form of reassurance about transitioning from hospitalization to community, reduced feelings of isolation, and enhanced continuity of care and recovery, (ii) TDM for community integration; clients believed that the intervention offered suitable friendships, was a tool for social connectedness, and helped to reduce stigma, (iii) encountered challenges, which included issues with trust, perceiving peer supporters as intruders, issues with communication, and initial fears about discharge and (4) suggestions for improving the TDM, such as, more in‐person interactions, formalizing the TDM and raising awareness about community resources. The TDM implementation may facilitate the transition from hospital to the community by offering social support that enhances recovery.