Sexual assault in the inpatient psychiatric setting

Betterly, Holly; Musselman, Meghan; Sorrentino, Renée

doi:10.1016/j.genhosppsych.2023.02.006

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…17 Various other adverse events may occur in inpatient psychiatric settings, ranging from breaches of privacy to sexual harassment. 18,19 When self-injury, violence, or other adverse events occur in these settings, inpatient psychiatric staff and administrators may face punitive repercussions. Examples might include sanctions by regulatory agencies (eg, loss of accreditation by the Joint Commission, fines by the Occupational Safety and Health Administration), litigation by patients or their families, and litigation by staff, among other possibilities.…”

Section: Frequency Of Adverse Eventsmentioning

confidence: 99%

How Inpatient Psychiatric Units Can Be Both Safe and Therapeutic

2024

AMA Journal of Ethics

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Inpatient psychiatric units should be therapeutic environments that support dignity and recovery. When adverse outcomes (eg, self-harm, violence) happen in these settings, clinicians and administrators can face litigation and other pressures to prioritize risk management over supporting patients' access to personal belongings, exercise equipment, and private spaces. This article describes these downward pressures toward sparser, controlling environments in inpatient psychiatric settings as a safety funnel and suggests strategies for balancing safety, humanity, and recovery in these contexts.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. Evolution of Inpatient Psychiatric UnitsInpatient psychiatric units are supposed to offer therapeutic environments for patients to recover from severe psychiatric symptoms. As far back as 1847, Thomas Story Kirkbride, a US physician, published "Remarks on the Construction and Arrangements of Hospitals for the Insane." 1,2 This treatise focused on all aspects of the design and organization of hospitals for people with mental illness, 2,3 such that, as Tomes argues, "every detail, from the design of the window frames to the table settings in the ward dining rooms, had to be arranged to sustain the impression that here was an institution where patients received kind and competent care." 1,3 Long-term psychiatric hospitals in the United States and elsewhere, often referred to as asylums, occasionally had sprawling facilities with acres of land, gardens, chapels, or other amenities for engendering tranquility among the inhabitants. 4,5,6 Although large, often state-run, facilities played a considerable role in the care of people with mental illness into the 20th century, by mid-century, increased public awareness of the conditions inside certain facilities, growing emphasis on patients' rights, and other developments led to a shift away from these types of facilities toward community-based care. 7,8 In parallel, the goal of psychiatric hospitalization shifted from long-term psychiatric and custodial care to short-term stabilization. 7,9 The evolution of inpatient psychiatric settings toward brief stays has coincided with increased clinical and legal emphasis on promoting safety and preventing adverse events. This article describes the Citation

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Section: Frequency Of Adverse Eventsmentioning

confidence: 99%

How Inpatient Psychiatric Units Can Be Both Safe and Therapeutic

2024

AMA Journal of Ethics

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Perspectives of Mental Health Nurses About Sexual Safety in Acute Inpatient Mental Health Units

Olasoji,

Taylah,

Megan

et al. 2024

Int J Mental Health Nurs

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The overall aim of this study is to explore the views of mental health nurses (MHNs) about the sexual safety of consumers receiving care in acute inpatient units. In Australia, people accessing mental health inpatient units have reported feeling unsafe while receiving care including experiences of sexual harassment and abuse from other patients. There has been no study to date that has explored the views of the MHNs providing care. An explorative descriptive qualitative study. Data were collected through semi‐structured interviews involving n = 8 MHNs working on a metropolitan acute inpatient unit recruited using purposive convenience sampling. Data were analysed using thematic analysis. The findings of this study highlighted the themes of ‘It's everyone's job to keep the patient safe’, ‘Going over expectations’, ‘Impact on patients’ and ‘Built environment’. Participants in this study believed that the sexual safety of patients in the inpatient unit is everyone's responsibility and that it was important during the admission process to ensure patients are aware of how to both seek help if needed and ensure that their actions or behaviours do not pose sexual safety concerns in others. Ensuring sexual safety in the mental health inpatient units is a complex issue that requires evidence‐based multipronged interventions involving all key stakeholders within the units.

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Physical, sexual and overall reported interpersonal violence against adult out-patients with severe mental illness under remission, receiving healthcare at Butabika hospital: A cross-sectional study

Guma,

Bangirana,

Birungi

et al. 2024

PLoS ONE

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Interpersonal violence is a significant public health and human rights concern. People living with severe mental illness are especially vulnerable. The Sustainable Development Goals 2030 Agenda aims to end violence. To this end, we gathered information on the prevalence and factors associated with interpersonal violence among one of the most impacted groups: individuals with severe mental illness at Butabika Hospital in Kampala, Uganda. We conducted a cross-sectional study in 2020, including individuals 18 years or older. Data was collected through a socio-demographics questionnaire and nine questions from the modified My Exposure to Community Violence Questionnaire. The assessment evaluated physical or sexual violence experience, frequency, and perpetrator identity. The data was analyzed using STATA version 12 through simple logistic regression to determine the correlation between a single exposure and the outcome of interest, with a significance level of 5%. Among 385 participants, the past year prevalence of overall reported interpersonal violence was about 34%, while physical and sexual reported interpersonal violence were approximately 29% and 11%, respectively. Participants who had perpetrated physical violence had higher odds of experiencing reported interpersonal violence. With increasing age, the odds of experiencing reported interpersonal violence decreased; compared to those aged 18–24 years, those aged 35–44 years had AOR = 0.31 (95% CI: 0.14–0.70, p = 0.005), and those aged 45 years and above had AOR = 0.34 (95% CI: 0.15–0.80, p = 0.013). Reported interpersonal violence was high among the participants. While individuals of older age had lower odds of reporting interpersonal violence, those who had perpetrated physical violence in the past year had higher odds. Screening for interpersonal violence among young patients is recommended. Psycho-education on preventing physical violence should be provided, especially to younger adults. The Ministry of Health should address violence against individuals with mental illness through mass sensitization. A prospective study could investigate risk and protective factors.

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Sexual assault in the inpatient psychiatric setting

Cited by 3 publications

References 27 publications

How Inpatient Psychiatric Units Can Be Both Safe and Therapeutic

How Inpatient Psychiatric Units Can Be Both Safe and Therapeutic

Perspectives of Mental Health Nurses About Sexual Safety in Acute Inpatient Mental Health Units

Physical, sexual and overall reported interpersonal violence against adult out-patients with severe mental illness under remission, receiving healthcare at Butabika hospital: A cross-sectional study

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