Exploring the use of body-worn cameras in acute mental health wards: A qualitative interview study with mental health patients and staff

Wilson, Keiran; Foye, Una; Thomas, Ellen; Chadwick, Madeleine; Dodhia, Sahil; Allen-Lynn, Jenny; Allen-Lynn, Jude; Brennan, Geoff; Simpson, Alan

doi:10.1016/j.ijnurstu.2023.104456

Cited by 14 publications

(15 citation statements)

References 19 publications

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“…The aims of BWCs were described as: increasing transparency; resolving incidents and complaints by providing accurate incident records; improving staff performance by providing footage for training and monitoring; improving staff conduct and patient behaviour; preventing incidents of aggression; improving safety and to “counter false allegations” [44,46,47,62].…”

Section: Resultsmentioning

confidence: 99%

“…Neither reported any conflicts of interest. One was rated high quality [62] and one low quality [47].…”

Section: Conflicts Of Interestmentioning

confidence: 99%

“…Staff (n = 2 papers) [47,62] • Some staff found BWCs caused discomfort to wear • Concern footage only captures from time of arrival, not the build up • Staff feel watched • Patients appear to feel intimidated by the technology • Some staff feel BWCs do not prevent violence and aggression because they treat it as an individual issue without addressing complex systemic causes.…”

Section: Conflicts O F Interest Negative Impacts Effects and Harmsmentioning

confidence: 99%

“…Patients (n = 2 papers) [47,62] • Negative impact on relationship between staff and patients with patients expressing hesitation about speaking with staff members wearing a camera, regardless of whether it is on or off.…”

Section: Nonementioning

confidence: 99%

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The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: A systematic review

Griffiths,

Saunders,

Foye

et al. 2024

Preprint

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Background: The use of surveillance technologies is becoming increasingly common in inpatient mental health settings, commonly justified as efforts to improve safety and cost-effectiveness. However, the use of these technologies has been questioned in light of limited research conducted and the sensitivities, ethical concerns and potential harms of surveillance. This systematic review aims to: 1) map how surveillance technologies have been employed in inpatient mental health settings, 2) identify any best practice guidance, 3) explore how they are experienced by patients, staff and carers, and 4) examine evidence regarding their impact. Methods: We searched five academic databases (Embase, MEDLINE, PsycInfo, PubMed and Scopus), one grey literature database (HMIC) and two pre-print servers (medRxiv and PsyArXiv) to identify relevant papers published up to 18/09/2023. We also conducted backwards and forwards citation tracking and contacted experts to identify relevant literature. Quality was assessed using the Mixed Methods Appraisal Tool. Data were synthesised using a narrative approach. Results: A total of 27 studies were identified as meeting the inclusion criteria. Included studies reported on CCTV/video monitoring (n = 13), Vision-Based Patient Monitoring and Management (VBPMM) (n = 6), Body Worn Cameras (BWCs) (n = 4), GPS electronic monitoring (n = 2) and wearable sensors (n = 2). Twelve papers (44.4%) were rated as low quality, five (18.5%) medium quality, and ten (37.0%) high quality. Five studies (18.5%) declared a conflict of interest. We identified minimal best practice guidance. Qualitative findings indicate that patient, staff and carer perceptions and experiences of surveillance technologies are mixed and complex. Quantitative findings regarding the impact of surveillance on outcomes such as self-harm, violence, aggression, care quality and cost-effectiveness were inconsistent or weak. Discussion: There is currently insufficient evidence to suggest that surveillance technologies in inpatient mental health settings are achieving the outcomes they are employed to achieve, such as improving safety and reducing costs. The studies were generally of low methodological quality, lacked lived experience involvement, and a substantial proportion (18.5%) declared conflicts of interest. Further independent coproduced research is needed to more comprehensively evaluate the impact of surveillance technologies in inpatient settings, including harms and benefits. If surveillance technologies are to be implemented, it will be important to engage all key stakeholders in the development of policies, procedures and best practice guidance to regulate their use, with a particular emphasis on prioritising the perspectives of patients.

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Section: Resultsmentioning

confidence: 99%

“…Neither reported any conflicts of interest. One was rated high quality [62] and one low quality [47].…”

Section: Conflicts Of Interestmentioning

confidence: 99%

Section: Conflicts O F Interest Negative Impacts Effects and Harmsmentioning

confidence: 99%

Section: Nonementioning

confidence: 99%

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The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: A systematic review

Griffiths,

Saunders,

Foye

et al. 2024

Preprint

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“…This research perspective allows for an exchange of experiences between the interviewee and the researcher, which can lead to answers that provide a better understanding of the issues. 19 The interviews were conducted using the Zoom platform, which is recognized as an innovative and easy-to-use interviewing platform, 20 and took place from February 18 to March 15, 2023.…”

Section: Methodsmentioning

confidence: 99%

Medical Response to the February 6, 2023, Earthquakes in Hatay: Challenges Faced in the Deadliest Disaster in the History of Türkiye

Tayfur,

Bayramoğlu,

Şimşek

et al. 2024

Disaster med. public health prep.

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Objective: The Kahramanmaraş earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground. Methods: This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach. Results: The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7. Conclusions: Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.

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When Should Inpatient Psychiatric Care Include Access to the Outdoors, Despite Elopement or Other Risks?

2024

AMA Journal of Ethics

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This commentary on a case considers consequences of a so-called "zerorisk" paradigm now common in psychiatric inpatient decision making. Iatrogenic harms of this approach must be balanced against promoting patients' safety and well-being. This article suggests how to collaboratively assess risk and draw on recovery-oriented goals of care.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.Case LH is a 29-year-old woman hospitalized, so far for 11 days, for a severe episode of depression. Dr Psych estimates she will be hospitalized for another week and is working with risk managers to find a way to allow LH to leave the unit with a staff member to walk in the hospital's garden, which LH can see from the unit's windows. LH feels distressed about not having access to fresh air. Dr Psych makes a case to a risk manager for LH's accompanied access to the garden: it will make her feel better, probably diminish her length of stay, and remove LH's feeling "imprisoned" as an obstacle to trust and healing in their patient-physician relationship. The risk manager, however, states: "I'm sorry; we just can't. Two years ago, a patient eloped after being allowed to walk in that garden." Dr Psych considers how to respond. CommentaryHealth care systems, particularly psychiatric care settings, are currently dominated by a zero-risk paradigm: an approach to ethical decision making that upholds elimination of risk as a shared goal and moral imperative. 1,2 The widespread adoption of the zero-risk approach has given rise to dedicated roles for risk managers and a range of interventions and technologies, including, in inpatient psychiatric settings, the use of surveillance, locked doors, and seclusion rooms, all aiming to eliminate risks associated with people experiencing mental health challenges. 3,4 Yet growing empirical evidence demonstrates that the zero-risk paradigm and its associated strategies fail to effectively eliminate or even reduce risks associated with self-harm, interpersonal violence, or absconding and instead threaten therapeutic relationships between health care professionals and patients. 5,6 Furthermore, zero-risk approaches introduce iatrogenic

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Exploring the use of body-worn cameras in acute mental health wards: A qualitative interview study with mental health patients and staff

Cited by 14 publications

References 19 publications

The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: A systematic review

The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: A systematic review

Medical Response to the February 6, 2023, Earthquakes in Hatay: Challenges Faced in the Deadliest Disaster in the History of Türkiye

When Should Inpatient Psychiatric Care Include Access to the Outdoors, Despite Elopement or Other Risks?

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