Professionals’ Perspective on Needs of Persons Who Frequently Use Psychiatric Emergency Services

Figures & data

Table 1. Overview of the participants.

	Individual interviews (n = 19)	Focus group (n = 1)
Gender
Male	6	4
Female	13	1
Age, median (range)	47 (29–70)	38 (32–49)
Profession
Assistant nurse	3 (13–17)^a	2
Registered nurse	10 (1–40)^a	2
Intern physician	2 (n/a)^a	0
Resident physician	4 (1–4)^a	1
Country of birth
Sweden	15	4
Other	4	1

^a Range of professionals’ experience of working in a PES, years.

Table 2. Examples of the analytical process.

Meaning unit	Condensed meaning unit	Code	Subcategory	Category
A: People don’t have … the safety net … surrounding network of contacts—friends, acquaintances, and parents, etc.—so this has sort of become some kind of new … people come here instead of … for things that you could maybe have taken care of within the family or with friends and so on, before.	People don’t have a surrounding social network of friends, acquaintances, and parents—they’re basically seeking help for loneliness.	People have no network of contacts and they’re seeking professional help because they’re lonely.	Need for significant others	Need to relieve loneliness
B: Maybe they have some diagnosis or …
A: Yes, you could also have that. But that they’re actually looking for help with loneliness. C: Yes, true, but that’s often how it is. (Focus group)
God Almighty! What they need help with … so actually we would need to sit down with the person and look at their entire history, see what it is like, what kind of network they have, what has been done and what has not been done, and what might be helpful, and what the person him/herself wants. Yes, and so … but I’m saying that … it’s of course really, really hard! We could, of course … and that is in fact the way it is, that it’s all about individual solutions, and that costs money and is totally unrealistic—and yes, that’s how it is. (SSK, interview 11)	Actually, we would need to sit down with the person and look at their entire history, see what it is like, what kind of network they have, what has been done and what has not been done, and what might be helpful, and what the person him/herself wants. But that’s of course really, really hard. Individual solutions cost money and are totally unrealistic.	No leeway for taking individual backgrounds and wishes into consideration.	Need for a long-term perspective	Need for cohesive care and support
But what we find is that certain municipalities don’t function properly. It’s as if they are unable to reach the patient … But it seems to me that the municipality could provide more support. … Like you must wait until the eleventh hour before you’re supposed to write an urgent care offer about the patient if the patient has, say, acute liver failure and is extremely somatically ill. It’s like nothing gets done until the very last minute. Yes. (ST, interview 1)	In certain municipalities it doesn’t work. They are unable to reach the patient. Seems to me that the municipality should provide more support. They wait until the last minute before writing an urgent care offer when the patient is very ill.	Municipalities should provide more interventions.	Need for improved social and healthcare functions	Need for cohesive care and support
		Municipalities should provide better service.
A: Yes, I think that … many of these people, who sometimes might function quite well otherwise, or well enough in any case, that they … they have to go to Emergency then, because there’s no other place that can …	People who function well have to go to Emergency because there’s nothing else open—even if it’s not an urgent psychiatric issue. Society is 24/7, but in healthcare things are still very rigid—as if getting sick is a daytime thing.	PES is the only service that is open round the clock.	Need for PES to be available	Need for cohesive care and support
B: … that’s open, right? Even though it may not involve an urgent psychiatric …
C: I’m actually about to start working at a municipality now, and there they’re talking about … or before I came they were talking about … how someone was going to have extended hours of opening at the support and treatment unit. One Saturday a month or something like that, and that’s a bit outside the box.
E: Yes, that it is.
C: At the same time, society is actually becoming ever more 24/7. But in healthcare and in the municipality things are still extremely rigid—there it’s like getting sick is a daytime thing. (Focus group)

Table 3. Overview of the theme, categories, and subcategories.

Theme	To suffer from illness, unfavorable life circumstances, and inadequate care stresses the need for sustainable support
Categories	Need to relieve loneliness	Need to relieve hopelessness	Need to relieve psychiatric symptoms	Need for cohesive care and support
Subcategories	Need for significant others	Need to master obstacles in everyday life	Need for increased well-being	Need for improved social and healthcare functions
	Need to fit into society	Need for meaning	Need for acute hospital admission and medication	Need for PES to be available
	Need for talk and interaction	Need for temporary escape	Need for self-admission	Need for collaboration between involved functions
	Need to be seen and confirmed	Need for caring encounters	Need to feel safe	Need for a long-term perspective