‘Time to spread my wings’ An investigative study exploring the effects of inpatient mental health rehabilitation What is the effect of inpatient mental health rehabilitation on an individual’s functional performance and do changes impact quality of life?

Abstract

This mixed methodology, 3-phase study at one NHS rehabilitation unit explores the experiences of 19 participants recruited over a 2 year period. Participants engaged in individual semi-structured interviews, and were invited to complete both the Lancashire Quality of Life Profile and the Assessment of Motor and Process Skills at admission, discharge and follow-up. Not all participants reached the point of discharge in the study period, and a few became too unwell to continue. At the point of follow-up, of the 10 remaining participants one dropped out due to work or educational commitments, three were re-admitted to hospital, and one did not come for appointments as agreed. To illustrate change over time, five participants have been brought to the fore through the use of case studies. The case studies synthesise the quantitative changes in the individual’s quality of life and functional performance with a personal narrative of their experience of their stay in the rehabilitation unit. The findings of the study are rich. Firstly, they highlight the range of losses experienced prior to rehabilitation and the importance of understanding this narrative as part of the recovery journey. Secondly, rehabilitation creates a sense of hope, but not all interactions with staff in the unit were viewed as hopeful. Hope was at its lowest when participants were not included in key decisions. Thirdly, while for some participants occupational performance and quality of life increased over time, for others it decreased. This study indicates tentative links between occupational performance and quality of life. Recommendations include enhancing client involvement in key decisions regarding rehabilitation choices, routine assessment of occupational performance levels, formally expanding rehabilitation into the community and considering grief work alongside more traditional rehabilitation interventions. Areas for further research include exploration of the links between quality of life and occupational performance levels.