Bullying among mentally-ill patients detained in a high-secure hospital: an exploratory study of the perceptions of staff and patients into how bullying is defined

Abstract

The present study is the first to explore patient-to-patient bullying within a secure psychiatric hospital housing mentally-ill patients. Its main aim was to provide an outline of the perceptions held by both patients and staff with regards to patient-to-patient bullying as opposed to providing an objective study of bullying. The total sample comprised 104 participants, 44 patients and 60 staff. These were sampled from wards housing male patients and wards housing female patients. All participants took part in a semi-structured interview based on that developed by Ireland and Ireland [2003] and Ireland [2005, 2004]. One quarter of participants stated they had seen a patient being bullied in the previous week, with staff perceiving a higher extent of bullying than patients. Differences between wards were minimal. It was predicted that theft-related bullying would be reported most frequently, that staff would identify a wider range of bullying behaviours than patients and that direct forms of aggression would be identified more readily as bullying than indirect forms. All predictions were supported. Problems in attempting to obtain a definition of bullying were also identified, with participants operating broader definitions than those found in the school-based literature. For example, bullying was not generally considered a repeated form of aggression, the severity of the aggression or provocative behaviour of the victim were not defining features, and it was felt bullying could be accidental. In summary, the current study highlights how patient-to-patient bullying does occur in services housing mentally-ill patients and that researching the behaviour may require the adoption of broader hospital-specific definitions of bullying. Aggr.

Aggression in a high secure hospital: staff and patient attitudes

“…We might tentatively relate these findings to the fact that patients in high secure hospitals can be as likely as staff to be victims of aggression (Uppal & McMurran 2009), and the findings from other studies in mental health settings that suggest that patients may acquire more serious injuries than staff (Foster et al 2007). Bullying between patients is not uncommon in high secure settings (Ireland 2006) and it has been observed that violence among patients in such settings may be used to establish a 'pecking order' and territorial boundaries (Love & Hunter 1999). The stressful nature of living within a high secure setting may therefore lead some patients to regard control of their more aggressive or dominant peers as being important for their quality of life.…”

“…2007). Bullying between patients is not uncommon in high secure settings (Ireland 2006) and it has been observed that violence among patients in such settings may be used to establish a ‘pecking order’ and territorial boundaries (Love & Hunter 1999). The stressful nature of living within a high secure setting may therefore lead some patients to regard control of their more aggressive or dominant peers as being important for their quality of life.…”

Bullying behaviours among mentally disordered offenders in a medium secure unit

“…Such research will be discussed here due to its relevance to the current study which was undertaken in a medium secure unit (MSU). Studies have predominantly been conducted in high secure forensic services with male personality disordered patients (Ireland, 2004(Ireland, , 2005Ireland and Bescoby, 2005), male mentally disordered patients (Ireland and Rowley, 2007) and mixed samples of both male and female patients (Ireland, 2006). Only one study to date has been conducted in a MSU with male mentally disordered patients (Cooper et al, 2011).…”

“…individuals with personality disorder more likely to be manipulative and planned with indirect behaviours whereas those with mental disorder may spontaneously act/react with direct behaviours). Ireland (2006) conducted the first study to explore the nature and extent of bullying behaviours among male and female mentally disordered patients in a high secure psychiatric hospital. In all, 30 per cent of female patients and 3 per cent of male patients reported being bullied in the previous week with only one female patient admitting to perpetrating bullying in the past week.…”

A qualitative study into the attitudes of patients and staff towards violence and aggression in a high security hospital

“…There is currently very little research conducted in high secure services (HSS) that focuses on the management of violence and aggression (MVA) in this context. Uppal & McMurran () report on the frequency and nature of incidents of violence, self‐harm and security and Ireland () consider bullying within this context. However, these studies do not focus specifically on the attitudes of staff and patients to violence and aggression.…”