The experiences of adults with a learning disability in specialist inpatient assessment and treatment units

• Main Author: Hill, Hayley
• Published: Cardiff University 2012
• Subjects: BF Psychology
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.567354

UK Government policy advocates that as far as possible, adults with a learning disability should be supported within mainstream community settings (Department of Health, 1993; 2001; 2007). However, for individuals who present with mental health problems or exceptional challenging behaviour, admission to a specialist inpatient unit is sometimes necessary. Despite a growing body of literature exploring service users’ views of community and healthcare services, research exploring their views and experiences of inpatient admission remains limited. The aim of the current study was to address this gap in the literature by conducting a qualitative exploration of service users’ experiences in specialist inpatient assessment and treatment units. The study employed a Grounded Theory methodology to obtain multiple perspectives on service users’ experiences, using semi-structured interviews with service users, carers and staff members. Verbatim interview transcripts were analysed in line with the Grounded Theory approach to develop a rich and in-depth understanding of service users’ experiences. From the data analysed, five core concepts were constructed which provided a theoretical model for understanding service users’ experiences of admission. This model proposes that service users’ experiences can be understood in relation to procedural aspects of ‘the course of admission’ as well as the psychological processes ‘sense of self and connectedness’, ‘sense of agency’ and ‘creating safety and protection’ which contribute to the construction of ‘understanding and meaning’. Findings are considered in relation to the existing literature and social constructionist, systemic and attachment theories. Clinical and service development implications from the research findings highlight the need for inpatient staff to consider the impact of psychosocial factors and processes on service users’ experiences, as well as the procedural aspects of admission. Recommendations are also made for maintaining family involvement, creating a context in which shared understandings between staff, carers and service users can be constructed, and developing links with community services.