title: Service users' experiences of residential alternatives to standard acute wards: qualitative study of similarities and differences.
abstract: BACKGROUND
  Little is known about the preferences and experiences of people with mental illness in relation to residential alternatives to hospital.
  
  
  OBJECTIVE
  To explore patients' subjective experiences of traditional hospital services and residential alternatives to hospital.
  
  
  METHODS
  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.
authors.affiliation: National Addictions Centre, PO Box 48, Institute of Psychiatry, King's College London, London SE5 8BB. helen.gilburt@iop.kcl.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Gilburt
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
authors.forename: Brynmor
authors.initials: B
authors.lastname: Lloyd-Evans
authors.forename: Sonia
authors.initials: S
authors.lastname: Johnson
authors.forename: David P J
authors.initials: DP
authors.lastname: Osborn
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003068:Coercion; D003155:Community Mental Health Centers; D004739:England; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation / Q000628:therapy*; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology*; D061214:Patient Safety; D011369:Professional-Patient Relations; D036301:Qualitative Research; D055815:Young Adult