Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway

Figures & data

Frame 1. An extract from one interview with preliminary notes and themes, and the development into to one of the overarching themes and final descriptions.

Original transcript
Interviewer: Mmm, but can you tell me a bit more about that, because
you say that having conversations, you want them to be helpful. But did
you sometimes experience that it helped and sometimes that it didn’t or..?	Preliminary notes and themes
Susan: Yes, sometimes it helped and sometimes it did not. And that has a lot, eh that has a lot to do with personal chemistry, for instance. There were someone who in a way said “yes but, yes that’s how it is having depression”, but that isn’t always helpful. And sometimes it helped that they just listened to what I had to say. And other times they put me on a different track. It seems as if many had good strategies to handle me and others had not. I had a pretty, just before I was discharged I had a terrible day where I could not speak to him the contact [among staff] I had that evening. So I ended up harming myself, cutting my thighs. And then I went to talk to the night staff, because I thought that I have to hold on to the night shift is coming and then I can talk to her. And she said “well, well”, I said I had a very bad night and that I was worried in a way before I was going to bed. And then she said “yes, it goes up and down for all of us in life, you know”. And then I tried to communicate that “I am really having a hard time now”, and then she said, “yes, but you have to think like [a Norwegian singer-songwriter], be an optimist”. And I interpreted it more like yes, “pull yourself together”. And then I just finished politely and smiled and said, “thanks for the conversation” and went to bed, that is, I went and sat down in the living room after I had taken medicine until I became so tired that I was sure to get to sleep when I went. So it was a little up and down how the conversations helped. However I mostly felt that it helped to have conversations.	Helpful conversations has a lot to with personal chemistry and connection with the professional. Focusing on mental disorder (depression) is not helpful. To be listened to is helpful. Thinks staff has different strategies to handle patients. Lack of connection with the contact among staff led to withdrawal and self-harm. Lack of understanding from the nurse. The suffering was not recognized or it was dismissed. Was left to take care of herself. Has both positive and negative experiences of the conversations with the staff.
One overarching theme: Experiences of support/lack of support from professionals This and other interview excerpts show that the participants experienced both support and lack of support from the professionals. Although they reported many positive experiences of being taken seriously, being listened to and taken well care of, they had examples (as illustrated in the excerpt above) of that their suffering and suicidality were not sufficiently recognized or responded to in a helpful way. Sometimes, it appeared that the staff focused much on mental disorders (e.g., depression) and/or they distanced themselves from the patients’ difficulties and suicidality, and it seemed as if they did not spend enough time to explore and respond to each person’s particular needs.
One final description: Seeking individualized treatment and care to feel recognized as a valuable person
Dwelling into the transcripts and reflecting further on the participants’ experiences led to the development of the final descriptions “seeking individualized treatment and care to feel recognized as a valuable person”, which entails that suicidal inpatients need to encounter professionals who treat them with respect, who are sensitive and recognize their suicidality and needs, and who make them feel like valuable fellow human beings.