-> doi.org/10.1016/j.apnu.2024.09.009.

The post New article: Tina Kirstine Vestphal, Frederik A. Gildberg, Rikke Jørgensen, Sara Rowaert, Ellen Boldrup Tingleff (2024) Family caregiver involvement in forensic mental health care – A qualitative study of healthcare professionals’ perceptions. first appeared on Forensic Mental Health Research Unit (RFM).

ABSTRACT
Background: In 2019, the Council of Europe agreed to urge member states to take steps toward total abolition of psychiatric coercive measures.
Aims: To test if this aspiration is perceived as realistic and what the alternative would be in the event of a total abolition, we surveyed members of the European FOSTREN network of mental health practitioners and researchers, which is specifically dedicated to exchanging knowledge on reducing psychiatric coercion to its minimum.
Methods: Web-based survey. Categorical responses were analyzed using frequencies, and free text responses were analyzed through thematic analysis.
Results: In total, out of 167 invitations to FOSTREN network members, 76 responded to the survey (Response Rate 45.5%). A minority (31%) of participating experts dedicated to the reduction of psychiatric coercive measures believed a total abolition to be an achievable goal. A commonly held belief was that total abolition is not achievable because mental health disorders are difficult to treat and may cause violence, necessitating coercion, and there is a need to protect the involved persons from harm. Those responding that complete abolition is achievable argued that the consequences of coercion outweigh any gains and indicated that use of advance directives are sufficient as alternatives to coercion.
Conclusion: Of a European group of experts specifically dedicated to the reduction of psychiatric coercion who participated in this questionnaire study, a minority believed a total abolition be an achievable goal. The study adds to the empirical evidence of the feasibility of the aspiration to totally abolish involuntary measures in the mental health services from the perspective of experts.

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Abstract
Introduction: The use of restrictive interventions is a violation of patients’ rights that
causes physical and psychological harm and which is a well-known challenge globally.
Mental health law and legislative principles and experts agree that when restrictive
interventions are applied, the least restrictive alternative should be used. However,
there is no consensus on what is the least restrictive alternative, especially from the
patient perspective.
Aim: To investigate the literature on mental health patients’ preferences regarding
restrictive interventions applied during admission to a psychiatric hospital.
Method: An integrative review informed by the PRISMA statement and thematic
analysis were undertaken.
Results: There were tendencies towards patients preferring observation and, for the
majority, mechanical restraint was the least preferred restrictive intervention. Factors
such as environment, communication and duration were found to influence patients’
preferences.
Discussion: There is a lack of agreement on how best to measure patients’ preferences and this complicates the choice of the least restrictive alternative. Nonetheless, our findings show that staff should consider environment, communication and duration when applying restrictive interventions.
Implications for Practice: More research on restrictive interventions and the least
restrictive alternative is warranted, but agreement is needed on standard measures,
and a standard global definition of restrictive interventions

The post Mental health patients’ preferences regarding restrictive interventions: An integrative review first appeared on Forensic Mental Health Research Unit (RFM).

ABSTRACT
Purpose: To explore mental health staff’s responses towards interventions designed to reduce the use
of mechanical restraint (MR) in adult mental health inpatient settings.
Methods: We conducted a cross-sectional, questionnaire-based survey. The questionnaire, made
available online via REDCap, presented 20 interventions designed to reduce MR use. Participants were
asked to rate and rank the interventions based on their viewpoints regarding the relevance and
importance of each intervention.
Results: A total of 128 mental health staff members from general and forensic mental health inpatient
units across the Mental Health Services in the Region of Southern Denmark completed the questionnaire
(response rate = 21.3%). A total of 90.8% of the ratings scored either ‘agree’ (45.2%) or ‘strongly agree’
(45.6%) concerning the relevance of the interventions in reducing MR use. Overall and in the divided
analysis, interventions labelled as ‘building relationship’ and ‘patient-related knowledge’ claimed high
scores in the staff’s rankings of the interventions’ importance concerning implementation. Conversely,
interventions like ‘carers’ and ‘standardised assessments’ received low scores.
Conclusions: The staff generally considered that the interventions were relevant. Importance rankings
were consistent across the divisions chosen, with a range of variance and dispersion being recorded
among certain groups.

The post Staff responses to interventions aiming to reduce mechanical restraint inadult mental health inpatient settings: a questionnaire-based survey first appeared on Forensic Mental Health Research Unit (RFM).

ABSTRACT
In forensic mental health care (FMHC), family caregivers perceive themselves as burdened in their relationships with the service user (the family member with mental illness) and by difficult collaboration with healthcare professionals (HCPs). There is a political objective to involve this group in the care and treatment of the service user in mental health care. To improve family caregiver involvement in care and treatment in FMHC, research about their perceptions is needed. This study aims to explore family caregivers’ perceptions of their interactions with the service user and HCPs. The method used was qualitative. Semi-structured, in-depth interviews with 12 family caregiver participants were carried out and analyzed thematically. The analysis resulted in three interrelated main themes: Strategies to normalize everyday living; Distrust of the quality of care; and Loss and grief. Family caregiver feelings of loss and grief may be suppressed, which additionally could prevent them from supporting the service user.

The post New article published: Tilting at Windmills first appeared on Forensic Mental Health Research Unit (RFM).

We examined previous researcher’s attempts to involve patients in the design and development of mental health research on acute mental health wards.

We explored milieu and contagion, and how staff as well and patients perceive this. We continue to underestimate the impact of environment/milieu on wards.

We co-designed a digital intervention with staff & patients. #WardSonar was deployed on a number of wards, our researchers collected our data, observed and interviewed patients and staff about #WardSonar to understand how to implement technology onto wards in a more robust way.

We looked at similarities and differences in what patients and staff thought about #WardSonar’s potential to make wards safer.

We learnt about how to develop digital interventions for clinical environments, and made recommendations about how to implement them on wards in the future.

We reported our main findings (under review) which suggest when patients tell you the ward is becoming unsafe incidents are more likely to happen in the next 4 hours.

Patients could also anonymously suggest what was making things unsafe e.g. other patients, staff or the environment. The challenge remains, getting staff to use real-time data to become more pro-active thereby preventing incidents, the very thing my very 1st paper focused on 25 years ago…Thanks to the team, staff and patients involved, particularly during Covid. We need to build on this work to examine the implementation of co-designed (not imposed) technologies on wards to make them safer.

Citation: Baker J, Kendal S, Bojke C, Louch G, Halligan D, Shafiq S, et al. A service-user digital intervention to collect real-time safety information on acute, adult mental health wards: the WardSonar mixed-methods study. Health Soc Care Deliv Res 2024;12(14) https://doi.org/10.3310/UDBQ8402

With permission from John Baker Orginal: https://mentalhealthresearchinleeds.co.uk/2024/05/22/wardsonar-report-published/

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