Barriers to Discharge for Nursing Home Residents With Serious Mental Illness

What barriers are associated with discharging residents with serious mental illness, such as bipolar disorder, schizophrenia, or psychotic disorders, from nursing homes?In this qualitative study including 15 staff members from 8 nursing homes across the US, participants reported multifaceted barriers to discharge for residents with serious mental illness from individual characteristics to relational and structural issues. Barriers included resident behaviors due to serious mental illness, limited access to psychiatric treatment, lack of robust social support networks, limitations in insurance coverage, and waiting lists for limited alternative housing options.These findings suggest that facilitating discharge from nursing homes to the community for residents with serious mental illness may require complex strategies that consider individual, relational, and structural interventions, ranging from education for staff and families to tiered supportive residential housing options.

Corresponding Author: Hannah C. Ratliff, PhD, RN, Department of Psychiatry, University of Michigan, 2800 Plymouth Rd, North Campus Research Complex, Bldg 16, Room 254S, Ann Arbor, MI 48109 (hratliff@umich.edu).

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