Acute day units for mental health crises: a qualitative study of service user and staff views and experiences
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Abstract
BACKGROUND: Acute Day Units (ADUs) provide intensive, non-residential, short-term treatment for adults in mental health crisis. They currently exist in approximately 30% of health localities in England, but there is little research into their functioning or effectiveness, and how this form of crisis care is experienced by service users. This qualitative study explores the views and experiences of stakeholders who use and work in ADUs. METHODS: We conducted 36 semi-structured interviews with service users, staff and carers at four ADUs in England. Data were analysed using thematic analysis. Peer researchers collected data and contributed to analysis, and a Lived Experience Advisory Panel (LEAP) provided perspectives across the whole project. RESULTS: Both service users and staff provided generally positive accounts of using or working in ADUs. Valued features were structured programmes that provide routine, meaningful group activities, and opportunities for peer contact and emotional, practical and peer support, within an environment that felt safe. Aspects of ADU care were often described as enabling personal and social connections that contribute to shifting from crisis to recovery. ADUs were compared favourably to other forms of home- and hospital-based acute care, particularly in providing more therapeutic input and social contact. Some service users and staff thought ADU lengths of stay should be extended slightly, and staff described some ADUs being under-utilised or poorly-understood by referrers in local acute care systems. CONCLUSIONS: Multi-site qualitative data suggests that ADUs provide a distinctive and valued contribution to acute care systems, and can avoid known problems associated with other forms of acute care, such as low user satisfaction, stressful ward environments, and little therapeutic input or positive peer contact. Findings suggest there may be grounds for recommending further development and more widespread implementation of ADUs to increase choice and effective support within local acute care systems.
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SMI symptomatology, that is, social difficulties, represents another possible factor that may influence the characteristics of the interventions; carrying out a group intervention could favour the patient's opportunities for peer contact and emotional, practical and peer support, within a safe environment for them.
“SMI symptomatology, that is, social difficulties, represents another possible factor that may influence the characteristics of the interventions; carrying out a group intervention could favour the patient’s opportunities for peer contact and emotional, practical and peer support, within a safe environment for them.65”
From Occupational therapy interventions for adults with severe mental illness: a scoping review (2021) · cites this paper as [65]
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Occupational therapy interventions for adults with severe mental illness: a scoping review
Rocamora-Montenegro, M., Compañ-Gabucio, L.-M., & Garcia de la Hera, M. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-047467 · Cited by 45 · see citing works
- Authors
- Morant, N., Davidson, M., Wackett, J., Lamb, D., Pinfold, V., Smith, D., Johnson, S., Lloyd-Evans, B., & Osborn, D. P. J.
- Affiliations
- University College London (GB)
- McPin Foundation (GB)
- Corresponding author
- Morant, Nicola
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2021-03-10
- Volume
- 21
- Issue
- 1
- Pages
- 146-146
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC7944597
- OpenAlex
- W3108787434
- Cited by
- 17
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 6
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Edwards Lifesciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Keywords
- mental health crisis care, service user experiences, employee experience, caregiver perspectives, peer support, group activities, length of hospital stay, peer researchers
- MeSH terms
- Adult, Mental Disorders, England, Humans, Mental Health, Mental Health Services, Caregivers, Qualitative Research
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