Psychiatric readmission: an integrative review of the literature

Abstract

Background: In the global context of contemporary psychiatric deinstitutionalization, the phenomenon of psychiatric readmission imposes important challenges, as it exposes the fragility of the network of mental health services.

Aims: To gather, synthesize and analyse the national and international scientific literature regarding the phenomenon of psychiatric readmission in the context of deinstitutionalization.

Methods: Through the combination of descriptors, an integrative review was performed of publications from the period 1997 to 2010 included in the MedLine, PubMed, LILACS, SciELO and PsycINFO databases. Selection of the articles was based on pre-established inclusion and exclusion criteria. Three authors independently evaluated the eligibility of the articles. The level of inter-judge concordance was calculated, using the formula: agreement = Σ possible concordance subtracted from real discordance divided by the number of articles. Information about the selected studies was systematized and analysed.

Findings: Sixteen articles met the inclusion criteria. Studies conducted and published in international journals, mainly in the USA, with a quantitative approach predominated. In general, the studies addressed the phenomenon of psychiatric readmission after the restructuring of mental health care. The variables investigated were clinical and sociodemographic factors and the characteristics of the mental health service associated with readmission, as well as the programs developed specifically for patients vulnerable to hospital readmissions.

Conclusions: It was noted that the perspective of the patient regarding their readmissions, as well as the interface with the social and familial context in which they maintain their social relationships and care for their health, was largely unexplored by the literature.