Both sides of the story: A dyadic study of patient and clinician experiences during the psychiatric hospital admissions process

Background

As the focus on patient autonomy in psychiatric decision-making increases, the role of the clinician is often overlooked. While studies have examined the reasons why clinicians admit patients to hospital, there is little research investigating clinicians' experiences during the hospitalization process. The aim of this study was to collect data from patient-clinician dyads to examine how each party experienced the admissions process.

Methods

Patients admitted to five adult psychiatric wards in the UK were recruited to participate in an interview about their experiences of the hospitalization process. 164 patients were interviewed within one week of their admission. The admitting clinician in each case, as identified by the patient or a review of case notes, was sent a questionnaire about their experiences during the admission of that particular patient.

Results

42% of the questionnaires were returned, allowing for the analysis of 69 patient-clinician dyads. Clinicians reported that they felt pressure, beyond simple medical need, to admit the patient to hospital in 20 of 69 cases. A modified version of the MacArthur Perceived Coercion Scale was used to measure clinician coercion and clinicians reported high levels of perceived coercion during the admission process in over one-quarter (n = 19) of the cases. Further analyses will examine the relationship between patient and clinician experiences and will explore associations between clinician experiences and sociodemographic/professional characteristics.

Conclusion

This dyadic study of patients and clinicians will provide a better understanding of the pressures experienced by both parties during the psychiatric hospital admissions process. This may aid in the development of policies for improving the hospitalization process.