Consumers lived experiences and satisfaction with sub-acute mental health residential services

Quantitative results

Table 1 presents the sociodemographic data for all participants at Time 1 and for participants who completed surveys at Time 2.

Table 1 Sociodemographic data of participants

A total of 298 participants provided some data at Time 1 with 186 participants providing data at Time 2. Data at both timepoints was provided by 181 participants. No missing data were estimated and all assumptions underlying the chosen analyses were met. No outliers justified deletion.

Analysis of participants who provided data at Time 2 in comparison with those who did not complete Time 2 (Table 1) found no significant associations on any demographical variables except education level. Participants who provided data at Time 2 were more likely to have a tertiary qualification (51% versus 35%), χ2 (1, n = 290) = 7.50, p = 0.006. No significant differences were found between those who provided data at Time 2 and those who did not on the three QPR sub-scales.

Table 2 presents means and standard deviations for all measures completed at Time 1 and Time 2 for participants who provided responses at both timepoints. Significant increases were seen between Time 1 and Time 2 for the total QPR score, t(180) = 4.84, p < 0.001, d = 0.36, 95% CI [0.21, 0.51], and for intrapersonal QPR scores, t(180) = 5.21, p < 0.001, d = 0.39, 95% CI [0.24, 0.54]. No significant difference was found between interpersonal QPR scores at Time 1 and at Time 2. The mean MASS rating of PARC services was 36.96, and the mean INSPIRE rating was 83% for the relationships subscale and 71% for Support sub-scale.

Table 2 Descriptive data for quantitative measures (n = 181)

Table 3 presents the associations between the QPR change scores, and the INSPIRE and MASS scores at Time 2. The total QPR change score, and the intrapersonal and interpersonal QPR change scores were all moderately to strongly correlated. All QPR change scores were weakly correlated with the MASS score and with both subscales of the INSPIRE. The MASS was moderately to strongly correlated with both subscales of the INSPIRE. Both INSPIRE subscales were also strongly correlated with each other. No significant differences were found in the QPR, INSPIRE, or MASS in the context of the PARC service clusters [12].

Table 3 Correlations among quantitative measures

Ratings for each MASS question provide insight into participants’ satisfaction with their PARC service stay (Fig. 1). The majority of responses were positive regarding all aspects of the PARC service stay (Fig. 1).

Fig. 1figure 1

Ratings of MASS items (%)

Qualitative results

Four superordinate and 11 subordinate themes were identified from 170 responses to the three open-ended MASS questions. Of the 170 participants who responded to these questions, 166 answers were utilised in analysis as four participants did not respond to questions with enough detail to be analysed. Three superordinate themes came from participants’ views of the most helpful aspects of their PARC service stay: Feeling Connected, Finding meaning and Purpose, and Self-Empowerment were all embedded in participants’ recovery journeys. Participants’ views regarding what could be improved about PARC services were grouped under the superordinate theme of improvements to PARC services. These superordinate and subordinate themes, along with supporting quotes are presented in Table 4. Each of the four superordinate themes is also briefly described below.

Table 4 Superordinate and subordinate themes with quotesFeeling connected

Feeling connected involved receiving and engaging with support from staff, engaging in peer support and learning, and feelings of connection.

Participants noted the importance of having someone there who would listen when they needed to talk, including peer and key workers, and often described this as 24/7 support [Table 4(a)]. Engaging in peer support and learning was identified as important to participants’ recovery journeys, including the opportunities to connect with others who have faced or are facing similar issues, and fostering a sense of not being alone through recovery [Table 4(b)]. Participants noted the PARC service environment also fostered these connections by facilitating new friendships, socialising, and helping to develop supportive networks [Table 4(c)]. The importance of feeling connected was emphasised by experiences when participants felt disconnected, further comments on the MASS mentioned social isolation and lack of social engagement prior to their PARC service stay.

Finding meaning and purpose

Finding meaning and purpose involved participating in groups and outings and having daily responsibilities.

Finding meaning and purpose was viewed as important. Groups were described as important for participants in progressing their own recovery [Table 4(d)]. Participants described how having daily responsibilities and a sense of responsibility over the PARC service environment was helpful, consistent with the CHIME framework of recovery where finding meaning and purpose is crucial is one’s recovery journey. For example, one participant described how having responsibilities meant contributing to the upkeep of their residence and feeling part of a ‘team’ [Table 4(e)].

Self-empowerment

Self-empowerment involved rebuilding myself, having choice and being in a healthy and safe environment in which to start and continue one’s recovery.

Self-empowerment included rebuilding myself, that related to regaining hope, confidence, self-esteem and new or old skills in oneself and one’s, life which one may gain through attending a PARC service. Some participants described the role of the staff in assisting them to gain skills to self-manage their mental health conditions and have choice in their recovery, including in regard to medications [Table 4(f)]. For some participants, having choice in one’s life was a key element in becoming empowered. Having choice over how they spent their time and being able to come and go as they pleased from the PARC service enabled participants to become more active, independent, and express choice in their lives during and beyond their PARC stay [Table 4(g)].

Improvements to PARC services

Participants spoke about improvements to PARC services, which could be understood as interlinked; these included: increased support, increased funding, and better facilities.

The need for increased support was identified by some participants who reported either feeling unsupported in their recovery or not acknowledged by staff, with staff spending more time in the office rather than with consumers themselves; or feeling as if they were “forced out” of the service before they were ready. Suggestions for improving support included more supportive staff, increased interaction with staff, more extensive planning and support for discharge, more staff on shift, professional and communicative staff, and more groups and outings [Table 4(i)].

Increased funding for PARC services was a common suggestion to reduce waiting list times. Some participants described this as the need for greater accessibility and increased length of stay at PARC services [Table 4(j)]. Participants also suggested that PARC services could improve by having better facilities for engaging with peer support workers and other professionals, including one-on-one sessions with psychologists, as well as improving resources, such as better soundproofing and mattresses, a minibus for outings, internet access, and pets [Table 4(k)].

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