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Peer-reviewedCC BY 4.0The Australian and New Zealand Journal of Psychiatry

Carer perceptions of inpatient psychiatric hospitals and the treatment of their loved ones: A meta-review of the literature

  • Katarina Khitra1
  • Matthew Modini1,2
  • Maree J Abbott1
  1. 1School of Psychology, The University of Sydney, Camperdown, NSW, Australia
  2. 2Concord Centre for Mental Health, Sydney Local Health District, NSW Health, Australia
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Abstract

Background:: Inpatient psychiatric admission remains a key intervention in severe mental illness; however, less is known about how informal carers perceive these settings. A meta-review, that is, a systematic review of systematic reviews, was conducted to synthesise factors shaping carers’ perceptions of inpatient psychiatric hospitals.

Method:: MEDLINE, PsycINFO and EMBASE were systematically searched for eligible reviews. Methodological quality was appraised using the AMSTAR-2 framework adapted for qualitative evidence, excluding reviews rated “Critically Low.” Thematic synthesis was used to detect key overarching factors that generalised across multiple reviews.

Results:: Seventeen systematic reviews were included, from which five key themes were identified: exclusion and disempowerment; communication and information deficits; emotional and care burden; systemic barriers and crisis-driven pathways and a desire for partnership and collaborative care.

Conclusion:: Carers frequently described experiencing marginalisation, confidentiality being applied in exclusionary ways, as well as fragmented services, particularly around involuntary admission and discharge. Findings highlight modifiable targets for practice, including family-inclusive routines, transparent information-sharing and structured involvement in treatment and discharge planning, which are crucial given the elevated post-discharge suicide risk. Addressing these factors may reduce carer burden, strengthen trust and improve perceptions of quality and safety in inpatient psychiatric care. Limitations of this meta-review and directions for future research are discussed.

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Cite

BibTeXRIS
BibTeX
@article{khitra2026carer,
  title = {{Carer perceptions of inpatient psychiatric hospitals and the treatment of their loved ones: A meta-review of the literature}},
  author = {Katarina Khitra and Matthew Modini and Maree J Abbott},
  journal = {The Australian and New Zealand Journal of Psychiatry},
  year = {2026},
  month = aug,
  doi = {10.1177/00048674261478446},
  url = {https://doi.org/10.1177/00048674261478446},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Carer perceptions of inpatient psychiatric hospitals and the treatment of their loved ones: A meta-review of the literature
AU  - Katarina Khitra
AU  - Matthew Modini
AU  - Maree J Abbott
PY  - 2026
DA  - 2026/08/18
JO  - The Australian and New Zealand Journal of Psychiatry
DO  - 10.1177/00048674261478446
UR  - https://doi.org/10.1177/00048674261478446
AB  - Background:: Inpatient psychiatric admission remains a key intervention in severe mental illness; however, less is known about how informal carers perceive these settings. A meta-review, that is, a systematic review of systematic reviews, was conducted to synthesise factors shaping carers’ perceptions of inpatient psychiatric hospitals.  Method:: MEDLINE, PsycINFO and EMBASE were systematically searched for eligible reviews. Methodological quality was appraised using the AMSTAR-2 framework adapted for qualitative evidence, excluding reviews rated “Critically Low.” Thematic synthesis was used to detect key overarching factors that generalised across multiple reviews.  Results:: Seventeen systematic reviews were included, from which five key themes were identified: exclusion and disempowerment; communication and information deficits; emotional and care burden; systemic barriers and crisis-driven pathways and a desire for partnership and collaborative care.  Conclusion:: Carers frequently described experiencing marginalisation, confidentiality being applied in exclusionary ways, as well as fragmented services, particularly around involuntary admission and discharge. Findings highlight modifiable targets for practice, including family-inclusive routines, transparent information-sharing and structured involvement in treatment and discharge planning, which are crucial given the elevated post-discharge suicide risk. Addressing these factors may reduce carer burden, strengthen trust and improve perceptions of quality and safety in inpatient psychiatric care. Limitations of this meta-review and directions for future research are discussed.
SN  - 0004-8674
SN  - 1440-1614
ER  -