Conflict management: A qualitative study of mental health staff's perceptions of factors that may influence conflicts with forensic mental health inpatients

Meanings of carers’ lived experience of “regulating oneself” in forensic psychiatry

“…Preserving oneself as a carer refers to carers’ lived experiences of dealing with and overcoming what was described as unwanted and conflicting emotions. Being a carer means being emotionally flexible and sensitive when encountering patients and finding a sense of tolerance to solve conflicting situations which is also emphasized in other studies (Gildberg et al, 2021 ). Caring within a forensic setting also means feeling unsupported and unprepared at times while dealing with ongoing internal obstacles as well as feelings of fear and experiences of powerlessness when dealing with the task at hand, findings in line with Harris et al ( 2015 ).…”

“…Stability is seen as a temporary condition in the community and is dependent on whether carers choose to be active or passive (Salzmann-Erikson et al, 2011 ). Taking responsibility, taking charge and being accountable for the relationship is of importance for carers (Kumpula et al, 2019 ) as well as having a sense of being in control (Hellzen et al, 1999 ) and feeling safe when performing caring actions (Gildberg et al, 2021 ). According to Salzmann-Erikson et al ( 2011 ), preventing turbulence and maintaining and restoring stability is accomplished from nursing care, if the patient is not experiencing a state of well-being, stability will less likely appear.…”

“…By accepting the patients’ worlds as part of their own, carers are also faced with a responsibility to “be there for the other” (Rydenlund et al, 2019 ), a notion that is intertwined with the findings of this study that emphasizes the importance of being a safe companion to maintain stability in the community. Finding a mutual sense of tolerance among colleagues prevents the individual carer too the use of restrictive and coercive actions (Gildberg et al, 2021 ). In cases when the patient’s expression is noticed as a fact and the carer does not engage in the patient’s expression, or if the carer does not care about what the patient is trying to convey and only states what the patient does or says as a fact, the patient’s actions or opinions are transformed into facts and the patient is objectified by means of these (Skjervheim, 1996 ).…”

A Nominal Group Technique to finalise Safewards Secure model and interventions for forensic mental health services

“…The reduction in the use of restrictive practices in mental health settings is a national priority in a number of countries (Fletcher et al., 2021; Maguire et al., 2019). Restrictive practices, sometimes referred to as containment or restrictive interventions, are defined as acts that are imposed on another person to restrict their movement, liberty and freedom, and are characterised by intrusions to privacy, personal space or body (Fletcher et al., 2017; Gildberg et al., 2021). Currently, legislation allows for the use of restrictive practices to manage conflict situations within mental health settings (Fletcher et al., 2017).…”

“…However, the use of restrictive practices has repeatedly been identified as an untherapeutic practice that risks physical and psychological injury to consumers and staff. The high degree of conflict and subsequent use of restrictive practices within inpatient mental health settings has been identified as a significant problem worldwide, and a growing body of research has emerged aimed at decreasing, and ultimately eliminating, these practices (Fletcher et al., 2017; Gildberg et al., 2021).…”