A meta-synthesis of the impact of COVID-19 on psychiatric inpatients, and an empirical study of the experiences of parenthood in forensic mental health settings

Davies, Kirstie 2024. A meta-synthesis of the impact of COVID-19 on psychiatric inpatients, and an empirical study of the experiences of parenthood in forensic mental health settings. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Paper 1 is a qualitative systematic review of the impact of the COVID-19 pandemic on psychiatric inpatients, including how the experience impacted their overall wellbeing, social relationships and coping. The COVID-19 pandemic brought about significant changes for everyone, including people residing in psychiatric hospitals. This population is often overlooked in society and likely felt the effects of the pandemic in disproportionate ways compared with others. There is a gap in the literature in this area which therefore warrants further exploration. By better understanding how psychiatric inpatients experienced the COVID-19 pandemic, suggestions for improving psychiatric inpatient care can be highlighted. This knowledge can also help services prepare for future outbreaks and make sure the voices of psychiatric inpatients are valued and heard. Searches were run on four databases to identify qualitative studies exploring the impact of COVID-19 on individuals residing in psychiatric inpatient settings. Nine qualitative studies were identified and included in this review. The Critical Appraisal Skills Programme (CASP) qualitative measure was utilized to assess the quality of each study. Thematic synthesis of the data led to three overarching analytical themes. The first theme; ‘Power dynamics and inequity’ described how heightened restrictions led to reduced autonomy and control, and also highlighted distinctions among inpatients and disparities between them and other populations amid the pandemic. The second theme; ‘Challenges in adapting’ emphasized the impact that the pandemic had on psychiatric inpatients’ mental wellbeing and symptoms, as well as increased feelings of isolation and loneliness. The third theme; ‘Silver linings’ highlighted newfound coping mechanisms, increased involvement in their care, and strengthened interpersonal connections. This thematic synthesis offers a contribution to the current literature by highlighting the significant challenges faced within psychiatric inpatient settings during the COVID-19 pandemic, with reports indicating worsening mental health symptoms and increased feelings of uncertainty, anxiety, and loneliness. Power disparities and inequities were exacerbated during this time, further complicating their experiences. However, amidst these difficulties, some positive outcomes emerged, such as discovering new coping mechanisms and strengthening connections with others. To address these challenges and expand on opportunities, ways of adapting clinical practices have been suggested in this review. Prioritizing patient autonomy, addressing power disparities, promoting relational connections, and recognizing patient resilience are proposed strategies. These recommendations aim to not only improve care during crises like pandemics but also enhance the everyday wellbeing of psychiatric inpatients. Paper 2 explored the experiences of parenthood for patients residing in forensic mental health settings. Becoming a parent is a significant life event. Being a ‘good parent’ according to popular societal views is often difficult for individuals, particularly those residing within forensic mental health settings, and can often bring up feelings of inadequacy. Existing literature on the experiences of parenthood with individuals in forensic mental health settings is limited and highlights a justification for exploring this area. Ten participants who were parents receiving care within medium-secure forensic mental health settings agreed to take part and were asked questions about their experiences and understandings of being a parent in hospital. Questions explored their parental identity, relationships with their children and support systems in hospital. An Interpretative Phenomenological Analysis (IPA) approach was used and the data produced three main themes; 1) Disempowerment; 2) Closeness amidst Adversity; 3) Personal Growth. The themes highlighted how parents felt a reduced sense of control and loss over being a parent, as well as not feeling able to show their true selves as parents in hospital. This means that feeling disempowered can impact how individuals in forensic mental health settings see themselves as parents. The importance of participants maintaining a feeling of parental closeness and identity whilst in hospital emerged in the findings. Staying connected with their children while in the hospital improved participant wellbeing and strengthened their sense of wellbeing as a parent. Themes around personal growth, development and future hopes as a parent were also described by participants. This included their parental role being a significant motivating factor for their recovery. This study contributes to the existing literature by highlighting the meaning inpatients ascribe to being a parent in forensic mental health settings. Findings also suggest the importance of patients feeling supported and acknowledged as parents in hospital in supporting their wellbeing and recovery.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	27 August 2024
Last Modified:	28 Aug 2024 11:10
URI:	https://orca.cardiff.ac.uk/id/eprint/171584

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