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Article
Publication date: 1 February 2004

Heather Sequeira and Simon Halstead

The study examines the experiences of physical restraint procedures reported by nursing staff in a secure mental health service. Interview data were subjected to thematic…

Abstract

The study examines the experiences of physical restraint procedures reported by nursing staff in a secure mental health service. Interview data were subjected to thematic content analysis in accordance with grounded theory methodology.Nursing staff reported a range of emotional responses to the use of restraint procedures. They included anxiety, anger, boredom, distress and crying. In some cases these responses were confirmed by descriptions from patients.Staff coped with the emotional responses to restraint in a variety of ways. Some staff discussed the ‘stigma’ attached to showing feelings to other staff. They described how laughter was used to reduce stress following an incident and how distressing emotions had to be taken home. Some staff described how they had become ‘hardened’ to the experience of restraint. A substantial proportion of staff suggested that they had ‘no’ emotional reactions and many reported ‘automatic’ responding during a restraint event in which they did not feel any emotion.Possible implications of these responses and clinical practice are discussed.

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The British Journal of Forensic Practice, vol. 6 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 February 2002

Heather Sequeira and Simon Halstead

Despite the controversy surrounding physical restraint and seclusion in the care of vulnerable adults, the views of service users have had little impact on current…

Abstract

Despite the controversy surrounding physical restraint and seclusion in the care of vulnerable adults, the views of service users have had little impact on current practice. This paper reviews the literature documenting the personal views and experience of people with learning disabilities and severe mental health problems following these procedures.

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The Journal of Adult Protection, vol. 4 no. 1
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 1 April 2001

John Taylor and Simon Halstead

The England and Wales National Health Service (NHS) Executive's guidance on the discharge of mentally disordered people, including those with learning disabilities…

Abstract

The England and Wales National Health Service (NHS) Executive's guidance on the discharge of mentally disordered people, including those with learning disabilities, requires that risk assessment is a component part of the Care Programme Approach (CPA). The guidance indicates that whenever possible, risk assessments should be carried out systematically using a standardised approach. For a number of reasons, practitioners are resistant to moving away from reliance on clinical judgements when making their assessments. This paper explores the issues underlying this tension. A solution is offered to the difficulty clinicians often experience in incorporating risk assessment tools into their clinical practice. A case example is given to illustrate how clinical assessments of offenders with learning disabilities can be utilised to estimate the risks presented. By demonstrating this procedure, a protocol for reaching clinically defensible decisions about the risks presented by clients is described, which also allows for the targeting of priority therapeutic and management interventions.

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The British Journal of Forensic Practice, vol. 3 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 February 2002

Heather Sequeira and Simon Halstead

This study examines the experiences of physical restraint procedures reported by in‐patients of a secure mental health service. Interview data were subjected to thematic…

Abstract

This study examines the experiences of physical restraint procedures reported by in‐patients of a secure mental health service. Interview data were subjected to thematic content analysis in accordance with grounded theory methodology.Patients had differential experiences of similar physical procedures. Most reported some negative psychological experience of restraint. Anger and anxiety were two major themes. Some respondents held the perception that restraint was used to punish patients and several suggested that restraint incited further violence and aggression. Some female service users reported that restraint evoked flashbacks of previous sexual trauma.A subset of female respondents gave contrasting accounts of restraint, suggesting that they purposely brought about the restraint to gain a sense of containment or as a way to release feelings.Possible implications of these responses for clinical practice are discussed.

Details

The British Journal of Forensic Practice, vol. 4 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 April 2001

Simon Halstead, Alyson Cahill, Lalini Fernando and Mike Isweran

Thirty‐five patients who had received at least one year's treatment in a learning‐disability medium secure unit were followed up for a maximum of five years. A good…

Abstract

Thirty‐five patients who had received at least one year's treatment in a learning‐disability medium secure unit were followed up for a maximum of five years. A good treatment outcome was more common in those with significant learning disability. At the end of follow‐up, 21 subjects (60%) were living in the community with support. The early months after discharge were a peak period for relapse. A very low level of reconviction was found, affecting only one subject. Patients who were older on discharge were less likely to re‐offend. The two deaths that occurred during follow‐up, and the three patients who required special (high security) hospital referral, are reported in detail. The findings are contrasted with the only comparable study (Day, 1988).

Details

The British Journal of Forensic Practice, vol. 3 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 February 2002

David Crighton and Graham Towl

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The British Journal of Forensic Practice, vol. 4 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 February 2004

David Crighton and Graham Towl

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The British Journal of Forensic Practice, vol. 6 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 April 2001

Pat Frankish

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The British Journal of Forensic Practice, vol. 3 no. 1
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 October 2001

Norman McClelland, Graham Towl and David Crighton

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The British Journal of Forensic Practice, vol. 3 no. 3
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 1 February 2002

Hilary Brown

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The Journal of Adult Protection, vol. 4 no. 1
Type: Research Article
ISSN: 1466-8203

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