Chemical restraint: A qualitative synthesis review of adult service user and staff experiences in mental health settings

2021 ◽  
Author(s):  
Eimear Muir‐Cochrane ◽  
Candice Oster
Keyword(s):  
Mental Health ◽  
Service User ◽  
Qualitative Synthesis ◽  
Chemical Restraint ◽  
Mental Health Settings ◽  
Adult Service ◽  
Staff Experiences

scholarly journals Attitudes towards shared decision making in mental health: a qualitative synthesis

2017 ◽  
Vol 22 (3) ◽  
pp. 233-256 ◽  
Author(s):  
Emma Kaminskiy ◽  
Simon Senner ◽  
Johannes Hamann
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Service User ◽  
Service Users ◽  
Shared Decision ◽  
Qualitative Synthesis ◽  
Content Type ◽  
Mental Health Settings ◽  
Word Search

Purpose Shared decision making (SDM) prioritises joint deliberation between practitioner and service user, and a respect for service-users’ experiential knowledge, values and preferences. The purpose of this paper is to review the existing literature pertaining to key stakeholders’ attitudes towards SDM in mental health. It examines whether perceived barriers and facilitators differ by group (e.g. service user, psychiatrist, nurse and social worker) and includes views of what facilitates and hinders the process for service users and practitioners. Design/methodology/approach This review adopts the principles of a qualitative research synthesis. A key word search of research published between 1990 and 2016 was undertaken. Qualitative, quantitative and mixed methods studies were included. Findings In total, 43 papers were included and several themes identified for service user and practitioner perspectives. Both practitioners and service users see SDM as an ethical imperative, and both groups highlight the need to be flexible in implementing SDM, suggesting it is context dependent. A range of challenges and barriers are presented by both practitioners and service users reflecting complex contextual and cultural features within which interactions in mental health take place. There were qualitative differences in what service users and practitioners describe as preventing or enabling SDM. The differences highlighted point towards different challenges and priorities in SDM for service users and practitioners. Originality/value The presentation of nuanced views and attitudes that practitioners and service users hold represent an important and under reported area and offer insight into the reasons for the gap between idealised policy and actual practice of SDM in mental health settings.

scholarly journals Explorations of Cooperation and Recalcitrance in Secure Mental Health Hospitals

2016 ◽  
Vol 33 (S1) ◽  
pp. S462-S462
Author(s):  
M. McKeown ◽  
M. Chandley ◽  
F. Jones ◽  
K. Wright ◽  
J. Duxbury ◽  
...  
Keyword(s):  
Mental Health ◽  
Service User ◽  
Personal Responsibility ◽  
Medical Model ◽  
Structured Interviews ◽  
Coercive Measures ◽  
Secure Environment ◽  
Competing Interest ◽  
Staff Experiences ◽  
The Impact

This paper reports on the findings of three qualitative research studies undertaken within, respectively, medium and low secure units in one UK region, and a high secure mental health hospital in England (UK). The first study investigated alliance based involvement practices. The second explored service user and staff views and sense making of the notion of recovery. The third study is ongoing into service user and staff experiences of extreme coercive measures, such as forms of restraint and long-term seclusion or segregation. All studies utilised either semi-structured interviews or focus groups. All data was subject to thematic analysis.Selected and emergent themes include:– the importance of relationships and communication; security first; involvement as pacification;– different understandings of recovery; the importance of meaningful occupation; staff-service user relationships; recovery journeys and dialogue with the past; and recovery as personal responsibility;– good and bad coercion; cooperation, resistance and recalcitrance; and alternatives to coercion.Findings suggest that cooperation is largely framed by services in terms of compliance with a bio-medical model. The impact of the secure environment, whilst ever-present, is not an absolute constraint on the realisation of recovery or involvement objectives. The availability of extreme coercive measures raises some seemingly paradoxical understandings from both service user and staff perspectives. Critical social theory is drawn on to illuminate the tensions between cooperation and recalcitrance and suggest further exploration of their respective legitimacy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Life in acute mental health settings: experiences and perceptions of service users and nurses

2013 ◽  
Vol 24 (1) ◽  
pp. 90-96 ◽  
Author(s):  
D. Rose ◽  
J. Evans ◽  
C. Laker ◽  
T. Wykes
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Service User ◽  
Working Life ◽  
Service Users ◽  
Patient Interaction ◽  
Marginalised Groups ◽  
The Social ◽  
Mental Health Settings ◽  
The Uk

Background.Acute psychiatric provision in the UK today as well as globally has many critics including service users and nurses.Method.Four focus groups, each meeting twice, were held separately for service users and nurses. The analysis was not purely inductive but driven by concerns with the social position of marginalised groups – both patients and staff.Results.The main themes were nurse/patient interaction and coercion. Service users and nurses conceptualised these differently. Service users found nurses inaccessible and uncaring, whereas nurses also felt powerless because their working life was dominated by administration. Nurses saw coercive situations as a reasonable response to factors ‘internal’ to the patient whereas for service users they were driven to extreme behaviour by the environment of the ward and coercive interventions were unnecessary and heavy handed.Conclusion.This study sheds new light on living and working in acute mental health settings today by comparing the perceptions of service users and nurses and deploying service user and nurse researchers. The intention is to promote better practice by providing a window on the perceptions of both groups.

scholarly journals Shared and Supported Decision Making in Medication in a Mental Health Setting: How Far Have We Come?

2021 ◽  
Author(s):  
Sofia Pappa ◽  
Joshua Barnett ◽  
Sally Gomme ◽  
Anthi Iliopoulou ◽  
Ivan Moore ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Lived Experience ◽  
Service User ◽  
Best Practice ◽  
Good Practice ◽  
Mental Health Provider ◽  
Service Users ◽  
Mental Health Settings ◽  
Formed Part

AbstractPersonalised care involves shared decision making (SDM) across all levels including choice in medication. However, there are a number of barriers which prevent its effective implementation in routine mental health settings. Therefore, we undertook a study to benchmark current practice across clinical services of a large urban mental health provider. The study formed part of the trust-wide ‘Supported Decision Making in Medication’ Co-Production Project and aims to inform future recommendations in delivering against contemporary best practice, guidance and policy. A survey exploring the views and experiences of service users and prescribers on shared and supported decision-making in medication was carried out in West London NHS Trust. Questionnaires were fully co-designed and co-delivered by a group of health professionals and individuals with lived experience. There were 100 responses from service users and 35 from prescribers. There was some good practice where both parties reported good quality conversations concerning dialogic styles, collaborative process, information provided and range of choice offered. However, prescriber’s perception of their practice was not always mirrored by service user feedback whose experiences often depended upon the prescriber, the time available or the part of the service. Generally, service user experience fell short of the good practice cited by clinicians though there was noticeable variability. Commitment from organizations and increasing understanding from practitioners are vital in transforming SDM from rhetoric into reality. From our findings a further challenge is to ensure that prescribers and service users have the time, information and tools to implement it consistently.

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