Manual restraint, a type of physical restraint, is a common practice in inpatient mental health settings linked to adverse physical and psychological staff and patient outcomes. However, little is known about the use of manual restraint for compulsory nasogastric feeding of patients with anorexia nervosa within inpatient eating disorder settings. The present phenomenological study aimed to explore nursing assistants’ experiences of administering manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa. The study followed COREQ guidelines. Eight semi‐structured interviews were conducted with eight nursing assistants from one UK inpatient child and adolescent eating disorder service. Interviews were transcribed verbatim and analysed using thematic analysis. Three themes were extracted: An unpleasant practice, importance of coping, and becoming desensitized and sensitized. Nursing assistants commonly experienced emotional distress, physical exhaustion, physical injury and physical aggression as a result of their manual restraint use. Nursing assistants appeared to cope with their distress by talking with colleagues and young persons who were further in their recovery, and by detaching themselves during manual restraint incidents. The findings highlight that the use of manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa in the UK is a highly distressing practice for nursing assistants. It is therefore important that sufficient supervision, support, and training are made available to staff working in these settings.

ObjectivesSuicides by train have devastating consequences for families, the rail industry, staff dealing with the aftermath of such incidents and potential witnesses. To reduce suicides and suicide attempts by rail, it is important to learn how safe interventions can be made. However, very little is known about how to identify someone who may be about to make a suicide attempt at a railway location (including underground/subways). The current research employed a novel way of understanding what behaviours might immediately precede a suicide or suicide attempt at these locations.Design and methodsA qualitative thematic approach was used for three parallel studies. Data were gathered from several sources, including interviews with individuals who survived a rail suicide attempt (n=9), CCTV footage of individuals who died by rail suicide (n=16) and qualitative survey data providing views from rail staff (n=79).ResultsOur research suggests that there are several behaviours that people may carry out before a suicide or suicide attempt at a rail location, including station hopping and platform switching, limiting contact with others, positioning themselves at the end of the track where the train/tube approaches, allowing trains to pass by and carrying out repetitive behaviours.ConclusionsThere are several behaviours that may be identifiable in the moments leading up to a suicide or suicide attempt on the railways which may present opportunities for intervention. These findings have implications for several stakeholders, including rail providers, transport police and other organisations focused on suicide prevention.

Suicide prevention strategies must be tailored to the needs of probation clients across the UK. Mandatory training for probation staff is recommended to help reduce suicides, and support from external agencies should be sought where possible.

BackgroundThere is a suicide on the British railways every 36 hours. However, the reasons why people choose to die by train are not well understood.AimsTo explore factors influencing and discouraging the decision to attempt suicide on the railway networks.MethodWe conducted an online survey and qualitative interviews with individuals who had contemplated or attempted suicide by train.ResultsA total of 353 survey responders had considered and 23 had attempted suicide at rail locations (including railways and metro/underground); a third of these cases were impulsive. The most frequently reported motivations for contemplating or attempting suicide were perceptions of quick and certain lethality (54 and 37%, respectively) and easy access to rail settings (33 and 38%, respectively). The main factor discouraging people from rail suicide was its wider impact, especially on train drivers (19%). In qualitative interviews (N = 34) the desire to avoid intervention from others was also a common motivating factor for attempting suicide on the railway networks.ConclusionsPeople attempt suicide by train because railway settings are easy to access and because of an inaccurate perception of certain and quick lethality. Tackling exaggerated perceptions of lethality may help reduce suicides by train.Declaration of interestNone.

Building rapport during police interviews is argued as important for improving on the completeness and accuracy of information provided by witnesses and victims. However, little experimental research has clearly operationalised rapport and investigated the impact of rapport behaviours on episodic memory. Eighty adults watched a video of a mock crime event and 24-hours later were randomly allocated to an interview condition where verbal and/or behavioural (non-verbal) rapport techniques were manipulated. Memorial performance measures revealed significantly more correct information, without a concomitant increase in errors, was elicited when behavioural rapport was present, a superiority effect found in both the free and probed recall phase of interviews. The presence of verbal rapport was found to reduce recall accuracy in the free recall phase of interviews. Post-interview feedback revealed significant multivariate effects for the presence of behavioural (only) rapport and combined (behavioural + verbal) rapport. Participants rated their interview experience far more positively when these types of rapport were present compared to when verbal (only) rapport or no rapport was present. These findings add weight to the importance of rapport in supporting eyewitness cognition, highlighting the potential consequences of impoverished social behaviours for building rapport during dyadic interactions, suggesting ‘doing’ rather than simply ‘saying’ may be more beneficial.