Thursday, July 18, 2019

Family Involvement in Care of Hospitalized Psychiatric Patients May Boost Discharge Planning, Follow-up Care

Involving families and loved ones in care when psychiatric patients are hospitalized is associated with a greater likelihood of comprehensive discharge planning and follow-up care, a study in Psychiatric Services in Advance has found.

Morgan Haselden, M.P.H., of the New York State Psychiatric Institute and colleagues reviewed the records of 179 individuals hospitalized for a psychiatric condition in New York City in 2012 and 2013. They determined the involvement of family (including anyone close to the patient who provided support) in the patients’ care via documentation in the patients’ medical records of specific activities such as visiting with the patient or attending family therapy sessions. They also determined whether hospital staff had performed three discharge planning activities: communicating with an outpatient health care professional, scheduling a post-discharge mental health appointment for the patient, and forwarding a discharge summary to the provider the patient was scheduled to see. Finally, the researchers determined whether the patient had received follow-up care.

The researchers found that hospital staff were more than twice as likely to complete all three discharge activities for patients whose families visited them in the hospital, communicated with staff about services offered to families, or attended family meetings or therapy sessions than for those whose families did not engage in these activities. Patients were more than twice as likely to attend a mental health appointment within seven days of discharge if their families were contacted by hospital staff, communicated with hospital staff about the patient’s health or mental health, or discussed with staff the patient’s post-discharge treatment plan. Patients were more than three times as likely to attend a mental health appointment within 30 days of discharge if there had been any involvement between family and hospital staff.

“This finding lends support to the benefits of family involvement in mental health care and adds new evidence that these benefits extend to the psychiatric hospitalization setting,” the researchers wrote.

The researchers noted two caveats to their study. First, they stated that medical record documentation “should not be considered as fully representing actual activities and interactions, especially given the pace of inpatient care and the lack of uniform documentation standards.” Second, they noted that the findings may not be generalizable to rural settings because families in urban settings like New York City may live closer to hospitals or have greater access to transportation to visit patients.

The authors concluded, “Involvement of patients’ families is an inexpensive intervention, and although it is standard care for hospital staff to contact and involve families, such interactions do not always occur. Hospitals should formalize efforts to educate staff about the benefits of involving families in treatment and should implement standard procedures requiring contact and communication.”

For related information, see the Psychiatric Services article “Family Involvement in the Clinical Care of Clients With First-Episode Psychosis in the RAISE Connection Program.”

(Image: iStock/Stígur Már Karlsson/Heimsmyndir)