On the Inside: A Narrative Review of Mental Health Inpatient Services

Abstract

Summary This paper describes and discusses the results of a narrative review of inpatient mental health services in the UK. Four main themes emerge from the review: the growing pres sure on inpatient hospital services; the negative experience of inpatient services reported by many service users; the problematic nature of hospital discharge; and pos sible alternatives to hospital admission. This review also suggests that a failure to rec ognize and act on what appears to be happening in hospitals could result in inpatient care once again being subject to the scrutiny and criticism that cast a shadow over psy chiatric services in the 1960s and 1970s. To stop this happening, current government policy is right to focus attention back onto acute care through new guidance and by commissioning research. However, changes also need to take place at a practice level so that front line workers are familiar with conditions in local acute services and can challenge unacceptable behaviour/services in support of their service users. With cur rent changes in the make-up of local mental health services and a greater emphasis on partnership working between health and social care, it may be that social care practi tioners can do this not only from the outside, but increasingly 'on the inside' (from within integrated health and social care organizations).