Search results

This paper aims to examine the nature and prevalence of violence in a medium secure unit and to evaluate a personal defence training programme for staff working with mentally disordered offenders.

The paper identifies an existing training gap associated with traditional breakaway techniques and describes a process of piloting a new educational module known as the spontaneous protection enabling accelerated response (SPEAR) system. Structured questionnaires were used to collect demographic data and analyse staff confidence and perceptions of the training module. Clinician confidence in coping with patient aggression was measured before, immediately after and at three months following participation in the new programme.

A significant change in staff confidence was observed at two time scales after the training had been administered when compared with the pre‐test baseline total scores. Over 90 per cent of staff either agreed or strongly agreed that training in the new personal defence module provided a credible defence against sudden episodes of high‐risk violence.

The paper describes a proposed module of training that may provide a credible tertiary strategy for those frontline clinicians currently exposed to the risk of sudden, spontaneous episodes of close proximity violence where traditional breakaway techniques are likely to be ineffective. This paper would interest managers, trainers and specialist practitioners that are involved in the preparation and delivery of violence reduction initiatives aimed at promoting safer and therapeutic services.

The purpose of this paper is to conduct a systematic search of the peer-reviewed qualitative literature investigating the lived experience of seclusion for adults with mental health difficulties, to appraise the quality of the existing literature and synthesise findings. Background: seclusion is a controversial intervention for the short-term management of unsafe behaviours in inpatient mental health services. There has been some sporadic interest in service users’ experiences of this.

Systematic literature review and meta-synthesis: data sources – databases MEDLINE, EMBASE, CINAHL and PSYCINFO were searched in July 2015; review methods – the Joanna Briggs Institute’s Qualitative Assessment and Review Instrument tools for critical appraisal and data extraction were used to review papers and synthesise findings.

A small number of papers were found, which were of mixed quality.

The existing research is limited in both quantity and quality. Although most participants from the existing research described seclusion as mostly negative with the potential for causing iatrogenic harm, some described more positive experiences, often in the context of compassionate interactions with staff.