{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:11:17Z","timestamp":1790172677136,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Rising demand for mental health services worldwide has placed increasing pressure on acute inpatient services, where patient lengths of stay continue to grow. Long\u2010stay admissions (&gt;\u200960\u2009days) are linked to demographic, diagnostic and service\u2010related factors, with the United Kingdom reporting longer stays than other developed countries. National reforms aim to reduce unnecessary inpatient stays, but staff report high strain and burnout within current systems, reflecting systemic issues such as inadequate community support and limited discharge options. We aimed to examine staff experiences of working on acute mental health inpatient wards, focusing on long\u2010stay patients, to drive improvements in care quality and workforce sustainability. Six focus groups were conducted with a range of clinical staff working on acute wards (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200934). Themes were generated using inductive, reflexive thematic analysis, focusing on semantic content while also considering latent meanings. The following key themes were identified: (1) Structural and systemic conditions shaping care delivery, (2) Organisational processes constraining patient flow, (3) Emotional labour and burnout among staff, and (4) The cycle of institutionalisation and dependency. The findings evidenced that acute wards are under significant pressure, with long stays, delayed discharges, and repeat admissions driven not only by clinical need but also by gaps in housing, community services, and care coordination. Addressing these challenges requires investment in workforce development, stronger inter\u2010agency collaboration, and expanded community provision, enabling acute wards to fulfil their intended role as short\u2010term, recovery\u2010focused settings that provide person\u2010centred care for people in crisis.\n                  <\/jats:p>","DOI":"10.1111\/inm.70271","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T07:05:14Z","timestamp":1779260714000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cSet up to Fail\u201d: Staff Experiences of Caring for Long\u2010Stay Patients in Acute Mental Health Wards in England"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4798-9536","authenticated-orcid":false,"given":"Laura","family":"Sambrook","sequence":"first","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason C.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajan","family":"Nathan","sequence":"additional","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"},{"name":"Cheshire and Wirral Partnership NHS Foundation Trust  Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-2508","authenticated-orcid":false,"given":"Oladayo","family":"Bifarin","sequence":"additional","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"},{"name":"Research and Innovation, Mersey Care NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wilson","sequence":"additional","affiliation":[{"name":"Cheshire and Wirral Partnership NHS Foundation Trust  Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Cheshire and Wirral Partnership NHS Foundation Trust  Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Tait","sequence":"additional","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ashley\u2010Mudie","sequence":"additional","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Saini","sequence":"additional","affiliation":[{"name":"Faculty of Health, Innovation, Technology and Science Liverpool John Moores University  Liverpool UK"},{"name":"Cheshire and Wirral Partnership NHS Foundation Trust  Chester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_12_2_1","article-title":"Length of Hospitalisation for People With Severe Mental Illness","volume":"1","author":"Babalola O.","year":"2014","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2010.tb00255.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12510"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nin.12630"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jebo.2023.06.006"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2015.05.001"},{"issue":"1","key":"e_1_2_12_8_1","first-page":"42","article-title":"Supporting Best Practice in Reflexive Thematic Analysis Reporting in Palliative Medicine: A Review and Introduction to the Reflexive Thematic Analysis Reporting Guidelines (RTARG)","volume":"38","author":"Braun V.","year":"2024","journal-title":"Palliative Medicine"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01616-6"},{"key":"e_1_2_12_10_1","unstructured":"Centre for Mental Health.2024.\u201cMental Health Services in the UK in 2023: What the Latest NHS Benchmarking Findings Tell Us.\u201dhttps:\/\/www.centreformentalhealth.org.uk\/mental\u2010health\u2010services\u2010in\u2010the\u2010uk\u2010in\u20102023\u2010what\u2010the\u2010latest\u2010nhs\u2010benchmarking\u2010findings\u2010tell\u2010us\/."},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1192\/pb.bp.107.018507"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-02846-z"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1192\/pb.bp.116.055251"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-021-02215-5"},{"key":"e_1_2_12_15_1","unstructured":"Department of Health and Social Care.2024.\u201cRapid Review Into Data on Mental Health Inpatient Settings: Final Report and Recommendations. Rapid Review Into Data on Mental Health Inpatient Settings: Final Report and Recommendations\u2014GOV.UK.\u201d"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-10863-x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.12269"},{"key":"e_1_2_12_18_1","volume-title":"Asylums: Essays on the Social Situation of Mental Patients and Other Inmates","author":"Goffman E.","year":"1961"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/13651501.2015.1062522"},{"key":"e_1_2_12_20_1","unstructured":"Health Services Safety Investigations Body.2025.\u201cMental Health Inpatient Settings: Overarching Report of Investigations Directed by the Secretary of State for Health and Social Care.\u201dhttps:\/\/www.hssib.org.uk\/patient\u2010safety\u2010investigations\/mental\u2010health\u2010inpatient\u2010settings\/fifth\u2010investigation\u2010report\/pdf\/."},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2006.09.007"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12416"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12517"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2018.72"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjmh.2017.6.2.66"},{"key":"e_1_2_12_26_1","unstructured":"McIntyre J. C. L.Sambrook H.Roks et\u00a0al.2025. \u201cMental Health Care at Cheshire and Wirral Partnership (CWP) NHS Foundation Trust \u2010 A Quantitative View.\u201d Liverpool John Moores University."},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1521\/pedi_2021_35_528"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2013.06.011"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2022.2118685"},{"key":"e_1_2_12_30_1","unstructured":"NHS England.2019a.\u201cNHS Long Term Plan.\u201dhttps:\/\/www.longtermplan.nhs.uk\/."},{"key":"e_1_2_12_31_1","unstructured":"NHS England.2019b.\u201cNHS Mental Health Implementation Plan 2019\/20\u20132023\/24.\u201dhttps:\/\/www.longtermplan.nhs.uk\/wp\u2010content\/uploads\/2019\/07\/nhs\u2010mental\u2010health\u2010implementation\u2010plan\u20102019\u201020\u20102023\u201024.pdf."},{"key":"e_1_2_12_32_1","unstructured":"NHS England.2023a.\u201cAcute Inpatient Mental Health Care for Adults and Older Adults.\u201dhttps:\/\/www.england.nhs.uk\/long\u2010read\/acute\u2010inpatient\u2010mental\u2010health\u2010care\u2010for\u2010adults\u2010and\u2010older\u2010adults\/."},{"key":"e_1_2_12_33_1","unstructured":"NHS England.2024a.\u201cCommissioner Guidance for Adult Mental Health Rehabilitation Inpatient Services\u201d."},{"key":"e_1_2_12_34_1","unstructured":"NHS England.2024b.\u201cCommissioning Framework for Mental Health Inpatient Services\u201d."},{"issue":"4","key":"e_1_2_12_35_1","first-page":"137","article-title":"Providing Nursing Care for a Patient With Borderline Personality Disorder on an Acute Inpatient Unit: A Phenomenological Study","volume":"6","author":"O'Brien L.","year":"1997","journal-title":"Australian and New Zealand Journal of Mental Health Nursing"},{"key":"e_1_2_12_36_1","volume-title":"Acute Mental Health Inpatient Care Settings Within the UK (Doctoral Dissertation)","author":"Phillips C.","year":"2019"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1192\/pb.bp.113.043083"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2019.1581337"},{"key":"e_1_2_12_39_1","volume-title":"CCQI Standards for Inpatient Mental Health Services: Fourth Edition","author":"Royal College of Psychiatrists","year":"2022"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/21642850.2024.2365226"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2025.10826"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.23.020172.002203"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-020-01881-1"},{"key":"e_1_2_12_44_1","unstructured":"The King's Fund.2015.\u201cMental Health Under Pressure.\u201dMental_health_under_pressure_2015.pdf."},{"key":"e_1_2_12_45_1","unstructured":"The King's Fund.2024.\u201cMental Health 360: Acute Mental Health Care for Adults.\u201dhttps:\/\/www.kingsfund.org.uk\/insight\u2010and\u2010analysis\/long\u2010reads\/mental\u2010health\u2010360\u2010acute\u2010mental\u2010health\u2010care\u2010adults\/."},{"key":"e_1_2_12_46_1","unstructured":"World Health Organization.2025.\u201cOver a Billion People Living With Mental Health Conditions\u2014Services Require Urgent Scale\u2010Up.\u201dOver a billion people living with mental health conditions\u2014services require urgent scale\u2010up."}],"container-title":["International Journal of Mental Health Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/inm.70271","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/inm.70271","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/inm.70271","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:57:04Z","timestamp":1790171824000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/inm.70271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/inm.70271"],"URL":"https:\/\/doi.org\/10.1111\/inm.70271","archive":["Portico"],"relation":{},"ISSN":["1445-8330","1447-0349"],"issn-type":[{"value":"1445-8330","type":"print"},{"value":"1447-0349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70271"}}