Service users' experiences of residential alternatives to standard acute wards: qualitative study of similarities and differences.

BACKGROUND Little is known about the preferences and experiences of people with mental illness in relation to residential alternatives to hospital. AIMS To explore patients' subjective experiences of traditional hospital services and residential alternatives to hospital. METHOD In-depth interviews were conducted with 40 purposively selected patients in residential alternative services who had previously experienced hospital in-patient stays. Transcripts were coded and analysed for thematic content. RESULTS Patients reported an overall preference for residential alternatives. These were identified as treating patients with lower levels of disturbance, being safer, having more freedom and decreased coercion, and having less paternalistic staff compared with traditional in-patient services. However, patients identified no substantial difference between their relationships with staff overall and the care provided between the two types of services. CONCLUSIONS For patients who have acute mental illness but lower levels of disturbance, residential alternatives offer a preferable environment to traditional hospital services: they minimise coercion and maximise freedom, safety and opportunities for peer support.