Experiences of Repeat Users of Psychiatric Emergency Services

Background: Psychiatric emergency services (PES) remain a critical and under-examined area of the mental health services system. What little is known about the use of these services virtually ignores the experiences and perspectives of the people who use them. In order to provide critical psychiatric emergency care that best meets the needs of PES service users and providers, we need to better understand the experiences and perspectives of those seeking care. Methods: The Boston Community-Academic Mental Health Partnership (B-CAMHP) is a unique community-based participatory research (CBPR) partnership created to increase service user and family member involvement in all phases of mental health research. Five research associates with experience using PES, were recruited and trained to design and conduct a qualitative study on repeat PES users.Transcripts were audiotaped, transcribed and coded based on a rigorous, documented protocol. Results: Participant demographics will be presented,and five areas will be explored: why people say they use PES and what they hope to receive; instability in participants' lives; the role of substance use and abuse; mixed experiences with formal, semi-formal, and informal supports; and the absence of any discussion on hope, recovery or the future. Conclusion: Despite the chaotic nature of PES settings and the crises which precipitate their use, it is possible to conduct CBPR research in these settings and to engage service users . Our findings suggest that interventions to reduce frequent PES use must address the social context of the lives of PES users and not focus solely on clinical interventions.