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Open Access
Article
Publication date: 20 January 2023

Jaana Asikainen, Katri Vehviläinen-Julkunen, Eila Repo-Tiihonen and Olavi Louheranta

Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental…

1330

Abstract

Purpose

Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental health-care staff may use restrictive practices. The Six Core Strategies and debriefing exist for managing violence and restrictive practices in different mental health settings. Debriefing is used to get patients’ views on restrictive practices, ensure proper patient care and strengthen the role of patients as experts. This study aims to provide new information on debriefing implementation and how debriefing was used among different patient groups in a forensic hospital.

Design/methodology/approach

Quantitative seclusion time and debriefing reports (n = 524) were examined with Poisson regression analysis. Fisher’s exact test was used to determine the associations between debriefing and seclusion/restraint.

Findings

Debriefing (n = 524) was provided in 93% of violent episodes, which is an excellent result on an international level. There was significant variation in how often debriefing was used (p < 0.001) among different patient groups, i.e. dangerous, difficult-to-treat patients and criminal offenders whose sentences have been waived. Previous debriefing research has rarely specified what types of psychiatric patients have been subjected to seclusion or restraint.

Practical implications

The implementation of debriefing requires multiprofessional work within the organization and wards.

Originality/value

Debriefing seems to stimulate reflection at every level of a health-care organization, which fosters learning and can ultimately change clinical practices. The use of debriefing can strengthen the role of patients as well as professionals.

Details

The Journal of Forensic Practice, vol. 25 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Open Access
Article
Publication date: 16 January 2023

Antaine Stíobhairt, David Staunton and Suzanne Guerin

This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and…

Abstract

Purpose

This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and service users on seclusion in adult mental health services.

Design/methodology/approach

A systematic review informed by PRISMA guidelines was conducted, drawing from four databases, which were searched in August 2018 and August 2022. Only original empirical studies rated as having “major” relevance were included. Data were extracted from 31 studies and qualitatively synthesised through deductive analysis using recovery principles as themes.

Findings

There was limited evidence of perceptions of seclusion being being consistent with recovery principles, with greater evidence of perceptions that directly opposed them. Studies of service user perspectives highlighted this more often than staff perspectives. The findings highlight paradoxical relationships between care and control and conflicting rights and emphasise the need to openly acknowledge the complexity of seclusion and its interface with recovery.

Research limitations/implications

This review was developed in line with international best practice and the protocol was registered. Using a search string with only three components maximised sensitivity during searches and minimised the risk of relevant literature being missed. Limitations include the focus on studies where the full text was published in English.

Originality/value

This review makes a unique contribution, highlighting that, to the best of the authors’ knowledge, no studies to date have explicitly explored the perspectives and experiences of staff and service users on the use of seclusion in the context of recovery-oriented practice. The findings are relevant to clinical practice, policy and future research, including amending procedures and practices to partially reconcile seclusion and recovery where the seclusion is deemed necessary.

Details

Mental Health Review Journal, vol. 28 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Open Access
Article
Publication date: 30 January 2012

Nilamadhab Kar, Surendra P. Singh, Tongeji E. Tungaraza, Susmit Roy, Maxine O'Brien, Debbie Cooper and Shishir Regmi

In many UK mental health services, in-patient psychiatric care is being separated from community care by having dedicated in-patient medical team. We evaluated staff satisfaction…

Abstract

In many UK mental health services, in-patient psychiatric care is being separated from community care by having dedicated in-patient medical team. We evaluated staff satisfaction in this functionalised in-patient care. A survey was conducted amongst multidiscipli-nary staff from various teams using a questionnaire survey. On an average 14.3% of staff returned a satisfactory response for function-alisation, 57.3% had unsatisfactory response and others were undecided or perceived no change. There was no difference in responses amongst age, gender and professional groups. Mean scores of all groups were within unsatisfactory domain; however community staff compared to in-patient staff and staff with more than 5 years of experience compared to those with 1-5 years of experience returned significantly more unsatisfactory responses regarding functionalisation. Many positive and negative aspects of functionalisation were raised. The results of this evaluation suggest the need for further studies on the effectiveness of in-patient functionalisation. Short and long term clinical outcomes and the satisfaction of the patients should also be studied.

Details

Mental Illness, vol. 4 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

Open Access
Article
Publication date: 25 January 2010

Aghukwa Nkereuwem Chikaodiri

A few months from the time of this survey, the nearly completed inpatient psychiatric facility within the Aminu Kano Teaching Hospital's complex would be ready for admissions…

Abstract

A few months from the time of this survey, the nearly completed inpatient psychiatric facility within the Aminu Kano Teaching Hospital's complex would be ready for admissions. Understanding the health workers' level of experience of mental illness and their likely behavioural responses towards people with psychiatric illness, therefore, should be a good baseline to understanding their likely reactions towards admitting such patients within a general hospital setting.

The study, which used a pre-tested and adapted attribution questionnaire, was pro -spective and cross-sectional. Randomly selected health workers in Aminu Kano Teaching Hospital had their level of familiarity and attributions towards psychiatric patients assessed.

The respondents showed a high level of experience with mental illness, with more than 3 in 5 of them having watched movies on mental illness before. More than half of them held positive (favorable) attributions towards persons with mental illness on nine of the ten assessed attribution factors. Almost all held negative (unfavourable) opinion towards intimate relationships with such persons. Attribution factors, “Responsibility, “Anger”, “Dangerousness”, “Fear” and “Segregation” were significantly related to the respondents' level of education (P<0.05). Marital status of the respondents related significantly to “Pity” and “Avoidance” factors (P<0.05). Having watched movies on mental illness significantly related to “Responsibility” and “Fear” factors (P<0.05).

Programs designed to improve the health workers mental health literacy, and increased positive professional contacts with mentally ill persons on treatment, would further enhance their perceived positive attributions towards them.

Details

Mental Illness, vol. 2 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

Open Access
Article
Publication date: 23 November 2016

Stefan Gebhardt and Martin Tobias Huber

Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to…

296

Abstract

Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction and clinical variables at admission and discharge. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level.

Details

Mental Illness, vol. 8 no. 2
Type: Research Article
ISSN: 2036-7465

Keywords

Content available
Article
Publication date: 1 September 2001

18

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 14 no. 5
Type: Research Article
ISSN: 0952-6862

Open Access
Article
Publication date: 22 February 2011

Moshe Z. Abramowitz, Jacob Polackiewicz and Alexander Grinshpoon

A key strategy for improving the quality of mental health care is the design and implementation of a mechanism for on-site inspection and clinical auditing. We discuss the use of…

Abstract

A key strategy for improving the quality of mental health care is the design and implementation of a mechanism for on-site inspection and clinical auditing. We discuss the use of checklists in auditing providing an objective, comprehensive system for recording and analyzing multi-disciplinary, clinical auditing in mental health services. We believe such an approach can identify potential risks and allow for better decision making.

Details

Mental Illness, vol. 3 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

Open Access
Article
Publication date: 5 April 2022

Sofie Østergaard Jaspers, Dorte Raaby Andersen, Iben Louise Karlsen, Lars Peter Sønderbo Andersen, Paul Maurice Conway, Johnny Dyreborg and Birgit Aust

Work-related violence is a major occupational safety and health (OSH) issue. According to the concept of violence prevention climate, managers play a pivotal role in preventing…

Abstract

Purpose

Work-related violence is a major occupational safety and health (OSH) issue. According to the concept of violence prevention climate, managers play a pivotal role in preventing the risk of violence at work. However, research on this is scarce. The objective of this study was, therefore, to examine line managers' use of violence preventive practices in high-risk sectors.

Design/methodology/approach

The authors employed three different sources of data (semi-structured interviews and field notes from both leadership seminars and coaching sessions) that were collected in the context of an intervention study in Denmark aimed at improving violence prevention. The authors conducted a thematic analysis of violence prevention experiences among 16 line managers – eight from the prison and probation services and eight from psychiatric hospitals.

Findings

Using an existing prevention framework, the authors categorized the descriptions into three types of violence preventive practices used by the line managers across the two sectors: “preventing violence”, “managing episodes of violence” and “promoting the positive”. Especially the category “promoting the positive” is often neglected in the intervention literature.

Originality/value

The study identified new aspects of managers' violence preventive practices than those included in the violence prevention climate concept. Such knowledge may help organizations devise improved systems for violence prevention in high-risk sectors.

Details

International Journal of Workplace Health Management, vol. 15 no. 4
Type: Research Article
ISSN: 1753-8351

Keywords

Open Access
Article
Publication date: 19 October 2017

Melanie Hagen, Beatrice Faust, Nina Kunzelmann, Ozan Y. Tektas, Johannes Kornhuber and Helge H.O. Müller

Factitious disorder, commonly called Munchhausen's syndrome, is a rare disorder that lacks evidence-based guidelines. Reporting clinical cases is important for sharing clinical…

Abstract

Factitious disorder, commonly called Munchhausen's syndrome, is a rare disorder that lacks evidence-based guidelines. Reporting clinical cases is important for sharing clinical experiences and treatment strategies. The symptoms and progression of the following case have not been previously reported in the literature. Here, we report a case involving a 41-year-old Caucasian with a suspected psychosomatic disorder. After intensive multi-professional diagnostics, we concluded that the patient had factitious disorder. The symptoms in this case changed rapidly during treatment, which posed a challenge. For factitious disorder, establishing interdisciplinary exchange is important. Symptoms that are normally treated by internists are most commonly described in the literature. This case demonstrates that psychiatrists are challenged by this diagnosis and should consider the possibility of factitious disorder when seeing patients diagnosed with somatoform disorders. The most important clinical conclusion was the importance of involving the patients' relatives in the treatment of patients with factitious disorder.

Details

Mental Illness, vol. 9 no. 2
Type: Research Article
ISSN: 2036-7465

Keywords

Content available
Article
Publication date: 12 August 2013

70

Abstract

Details

Advances in Dual Diagnosis, vol. 6 no. 3
Type: Research Article
ISSN: 1757-0972

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