Forensic Psychiatric Patients’ Perspectives on COVID-19 Prevention Measures: A Qualitative Study

Terkildsen, Morten Deleuran; Vestergaard, Lea K.; Møllerhøj, Jette; Sørensen, Lambert K.

doi:10.1080/24732850.2022.2118095

Cited by 2 publications

(6 citation statements)

References 42 publications

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“…Patients in forensic mental health wards are often admitted for extended periods (Uhrskov Sørensen et al., 2020), making their social life and care and treatment regime highly dependent on strong patient–staff relations. Utilizing seclusion measures does, however, underline the custodial role of forensic mental health staff (Martin & Street, 2003; Terkildsen, Kennedy, et al., 2022; Terkildsen, Vestergaard, et al., 2022), and this role could prevent close patient–staff relationships, promote negative relational experiences and thereby act counterproductive to the individual patient's recovery process (Mann et al., 2014; Marshall & Adams, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Integrating patient perspectives in the development and implementation of such mental health practices are important to ensure their future success (Terkildsen, Vestergaard, et al, 2022, Kontio et al, 2010.…”

Section: R Ationalementioning

confidence: 99%

“…Current forensic mental health research underlines a need to study how to balance care and custody in forensic mental health practices in ways where the promotion and sustainment of strong care relations are realized while risks posed by patients are managed accordingly (Mann et al., 2014; Terkildsen, Kennedy, et al., 2022; Terkildsen, Vestergaard, et al., 2022).…”

Section: Rationalementioning

confidence: 99%

“…For nurses working in recovery‐orientated secure settings, however, the use of explicit power (in the form of risk management strategies) has been depicted in literature as providing nurses with a role marred by a specific ambivalence (Martin & Street, 2003; Terkildsen, Kennedy, et al., 2022; Terkildsen, Vestergaard, et al., 2022). On the one hand, they are to engage patients in rehabilitative practices.…”

Section: Rationalementioning

confidence: 99%

“…This study aims to fill this gap, by exploring the patients' experiences of different observation methods in seclusion and their influence on their connection and relations to staff, by patients in an Irish forensic mental health hospital, in order to inform future seclusion practices. Integrating patient perspectives in the development and implementation of such mental health practices are important to ensure their future success (Terkildsen, Vestergaard, et al., 2022, Kontio et al., 2010).…”

Section: Rationalementioning

confidence: 99%

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Patient perspective on observation methods used in seclusion room in an Irish forensic mental health setting: A qualitative study

Shetty,

Burke,

Timmons

et al. 2023

Psychiatric Ment Health Nurs

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Accessible SummaryWhat is known on the subject? Nurses‘ observation of patients in seclusion is essential to ensure patient safety. Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy. Direct observation and video monitoring are widely used in observing patients in seclusion. Coercive practices may cause distress to patient‐staff relations. What the paper adds to existing knowledge? We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients. Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness. Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized. Observation via camera and nurses‘ presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion. Pixellating the video camera would give a sense of privacy and dignity. What are the implications for practice? The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients‘ unique needs. A consistent approach to relational contact and communication is essential. A care plan must include patient‘s preferred approach for interacting while in seclusion to support individualized care provision. Viewing panels (small window on the seclusion door) are important in establishing two‐way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients. Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient‘s presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness. More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations. Patient education is paramount. Providing prior information to patients using a co‐produced information leaflet might reduce their anxiety and make them feel safe in the room. When using cameras in the seclusion room, these should be pixelated to maintain patients‘ privacy. AbstractIntroductionA lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study.AimThe aim of the study was to explore patients’ experience of different methods of observation used while the patient was in seclusion.MethodA retrospective phenomenological approach, using semi‐structured interviews, ten patients’ experiences of being observed in the seclusion room was investigated. Colaizzi’s descriptive phenomenological method was followed to analyse the data.ResultsCommunicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion.DiscussionThe mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation.Implications for PracticeDifferent observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion.

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Section: Discussionmentioning

confidence: 99%

Section: R Ationalementioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

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Patient perspective on observation methods used in seclusion room in an Irish forensic mental health setting: A qualitative study

Shetty,

Burke,

Timmons

et al. 2023

Psychiatric Ment Health Nurs

Self Cite

View full text Add to dashboard Cite

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VR-assisted aggression treatment in forensic psychiatry: a qualitative study in patients with severe mental disorders

González Moraga,

Enebrink,

Perrin

et al. 2024

Front. Psychiatry

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IntroductionImprovements in virtual reality (VR) have made it possible to create realistic, virtual settings for behavioral assessment and skills training that cannot otherwise be accessed in a safe way in forensic psychiatric settings. VR interventions are under development but little is known how forensic psychiatric patients with severe mental disorders experience VR-assisted assessments or treatments.MethodsThe present study aimed to help fill this knowledge gap via qualitative interviews with seven patients with severe mental disorders at a high-security forensic psychiatric clinic who had completed the newly revised Virtual Reality Aggression Prevention Training (VRAPT). All participants were interviewed 12 weeks after the VRAPT intervention, and interview data analyzed with manifest inductive content analysis. ResultsSix manifest content categories were identified: 1. Therapeutic process, 2. VRAPT method, 3. VR technology, 4. Previous treatment experiences, 5. Challenges to treatment of aggression, and 6. Unexpected experiences. The participants had diverse experiences related to both the VRAPT intervention and forensic psychiatric care. Participants described a mixture of positive experiences in relation to VR-assisted role-plays, and less positive in relation to motivation for aggression-focused treatment and technological limitations. DiscussionThe present findings suggest further studies are needed on how to best implement VR-assisted treatments for aggression in forensic settings, and potentially further modification of treatment content in interventions like VRAPT.

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Forensic Psychiatric Patients’ Perspectives on COVID-19 Prevention Measures: A Qualitative Study

Cited by 2 publications

References 42 publications

Patient perspective on observation methods used in seclusion room in an Irish forensic mental health setting: A qualitative study

Patient perspective on observation methods used in seclusion room in an Irish forensic mental health setting: A qualitative study

VR-assisted aggression treatment in forensic psychiatry: a qualitative study in patients with severe mental disorders

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