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Nurses’ discourses of challenging behaviour in inpatient mental-health services

Amy Mellow (CAMHS North Team, Nottinghamshire Healthcare NHS Trust, Nottingham, UK)
Anna Tickle (Institute of Health, Work and Organisations, Nottinghamshire Healthcare NHS Trust, Nottingham, UK) (Department of Psychology, University of Nottingham, Nottingham, UK)
David M. Gresswell (Department of Psychology, University of Lincoln, Lincoln, UK)
Hanne Jakobsen (South London and Maudsley NHS Foundation Trust, London, UK)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 17 October 2018

Issue publication date: 7 November 2018




Nurses working in acute mental-health services are vulnerable to occupational stress. One stressor identified is the challenging behaviour of some service users (Jenkins and Elliott, 2004). The purpose of this paper is to discuss the discourses drawn on by nurses to understand challenging behaviour and talk about its management.


Nurses working on acute and psychiatric intensive care unit (PICU) wards were interviewed, and data were analysed using discourse analysis.


Biomedical and systemic discourses were found to be dominant. Alternative psychosocial and emotional discourses were drawn on by some participants but marginalised by the dominant biomedical construction of challenging behaviour.


Existing studies have not considered how discourses socially construct challenging behaviour and its management in inpatient mental-health services.



Mellow, A., Tickle, A., Gresswell, D.M. and Jakobsen, H. (2018), "Nurses’ discourses of challenging behaviour in inpatient mental-health services", Mental Health Review Journal, Vol. 23 No. 4, pp. 253-268.



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