Safewards Impact in Inpatient Mental Health Units in Victoria, Australia: Staff Perspectives

Frontiers in Psychiatry

Justine Fletcher²  Bridget Hamilton³  Stuart A. Kinner⁴  Lisa Brophy⁷ 

[1] Centre for Adolescent Health, Murdoch Children’s Research Institute, Heidelberg, VIC, Australia;Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia;Centre for Psychiatric Nursing, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia;Griffith Criminology Institute, Griffith University, Mt Gravatt, QLD, Australia;Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia;Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia;Mind Australia Limited, Heidelberg, VIC, Australia;School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, Australia;

关键词: mental health service;    safewards;    inpatient psychiatry;    restrictive practices;    recovery oriented care;   

DOI  :  10.3389/fpsyt.2019.00462

来源: DOAJ

【 摘 要 】

Introduction: Mental health professionals working in acute inpatient mental health wards are involved in a complex interplay between an espoused commitment by government and organizational policy to be recovery-oriented and a persistent culture of risk management and tolerance of restrictive practices. This tension is overlain on their own professional drive to deliver person-centered care and the challenging environment of inpatient wards. Safewards is designed to reduce conflict and containment through the implementation of 10 interventions that serve to improve the relationship between staff and consumers. The aim of the current study was to understand the impact of Safewards from the perspectives of the staff.Methods: One hundred and three staff from 14 inpatient mental health wards completed a survey 12 months after the implementation of Safewards. Staff represented four service settings: adolescent, adult, and aged acute and secure extended care units.Results: Quantitative results from the survey indicate that staff believed there to be a reduction in physical and verbal aggression since the introduction of Safewards. Staff were more positive about being part of the ward and felt safer and more connected with consumers. Qualitative data highlight four key themes regarding the model and interventions: structured and relevant; conflict prevention and reducing restrictive practices; ward culture change; and promotes recovery principles.Discussion: This study found that from the perspective of staff, Safewards contributes to a reduction in conflict events and is an acceptable practice change intervention. Staff perspectives concur with those of consumers regarding an equalizing of staff consumer relationships and the promotion of more recovery-oriented care in acute inpatient mental health services.

【 授权许可】

Unknown