A psychosocial reconceptualization of the psychiatric readmission

Student thesis: Master thesis (including HD thesis)

  • Bastian Sand Mørkeberg
4. term, Social Work, Master (Master Programme)
Readmission rates for psychiatric hospitalization is used to measure the quality of psychiatric inpa-tient care in Denmark and many other countries. However, the validity of readmission rates as an indicator for measuring the quality of psychiatric functions is not clear. This is partly because the majority of scientific studies regarding psychiatric readmission has neglected to investigate and explain the complex psychosocial mechanisms that presupposes psychiatric readmissions. In this thesis I attempt to contribute to this gap in the scientific literature about psychiatric readmissions. I do so by combining the metatheory of Critical Realism with the methodology of Grounded Theo-ry, in an explorative investigation of the aforementioned psychosocial mechanisms.
In Denmark psychiatric readmissions are often characterized as cyclical movements between two public sectors: the municipalities and the regions. Therefore, this investigation was conducted via semi-structured interviews with residents at social-psychiatric housing facilities with readmission experience, and social workers at the housing facilities, in the municipalities. Furthermore, I inter-viewed psychiatrists working in psychiatric hospitals, in the regions. The aim with these interviews were to gather data that referred to the individual reasons behind and social structures that condi-tion readmissions. Critical Realist Grounded Theory enabled me to construct a theory grounded in this data that explains the contours of a small number of psychosocial mechanisms.
Readmissions emerge as cyclical compromises of relatively normalizing temporal displacements. When a person is admitted to a psychiatric hospital, it is due to severe mental suffering that no other alternative intervention can handle or alleviate. The purpose of admission is to normalize patients to a relative extent, so that they might participate in their local environment upon dis-charge. This can at times result in counterproductive short-termed (re)admissions as patients are then discharged too quickly, whereby the patients need for care and adequate breaks from a dis-tressful existence are continually postponed.
My study shows that readmission rates should not be used to measure the quality of psychiatric functions. Readmission rates could however still be used as a tool for improving efficiency locally at each psychiatric hospital.
Publication date15 Nov 2022
ID: 498387393