How does the environment influence consumers' perceptions of safety in acute mental health units? A qualitative study

Abstract

Aims and objectives To explore how the physical and social environment of acute mental health units influences consumers' perception and experience of safety. Background Acute mental health units are places in which consumers should feel safe. Not all consumers, however, feel safe in this environment. Little is known about what contributes to consumers' feelings of safety in this setting. Design The study used a qualitative descriptive design, influenced by naturalistic enquiry. Data were analysed using thematic analysis and are reported according to the COREQ checklist. Methods Fifteen people who had experienced admission to an acute mental health unit were individually interviewed. Results Having a supportive environment enhanced consumers' perception and experience of safety. A supportive environment was experienced when consumers had privacy, felt safe from other consumers and had meaningful activities to participate in within the acute mental health unit. In contrast, having their privacy breached by other consumers made participants feel unsafe. Many participants were fearful of other consumers, and felt unsafe and unable to protect themselves. Lack of meaningful activities led to boredom and contributed to consumers feeling unsafe. Conclusions Personal spaces should address consumers' privacy needs without compromising staff access. Staff presence enhances consumers' feelings of safety, but this need can be heightened when consumers are unable to alert staff when they feel unsafe. Meaningful activities link consumers to their lives outside of the hospital and can enhance recovery. Relevance to clinical practice Understanding how the acute unit environment is perceived by consumers can assist nurses and managers to promote feelings of safety among consumers. Feeling safe can, in turn, optimise recovery.

How do hospital inpatients conceptualise patient safety? A qualitative interview study using constructivist grounded theory

“…Consistent with previous research,6 20 22–27 50–54 patients in this study discussed safety in the context of what made them ‘feel safe’. However, by moving beyond thematic description of patients’ reports to the generation of a conceptual model, this study provides important insights into how patients conceptualise safety including the ‘actors’ and ‘actions’ that influence how patients experience hospital care.…”

The efficacy of homestyle rehabilitation on negative symptoms in chronic schizophrenia: A randomized controlled trial

“…Homestyle rehabilitation offers a friendly and supportive social environment, providing more opportunities for individuals to engage with the wider community. This “hospital at home” approach also enables patients to receive therapeutic interventions from hospital staff, nurses, and therapists while staying in their own homes, which is consistent with the findings of Cutleer et al and Yanos et al, who emphasized the importance of immediate circumstances in recovery ( 43 , 44 ). Furthermore, Freeman and colleagues have noted that living in an intimate social group has a positive impact on health ( 45 ).…”

It’s Not Just in the Walls: Patient and Staff Experiences of a New Spatial Design for Psychiatric Inpatient Care

“…Both groups felt the atmosphere was calmer and contributed to fewer conflicts, increased safety, and brought them closer together. Patients in acute mental health units have been found to experience a greater feeling of safety in a supportive environment that allows them privacy, safety from other patients, and meaningful activities (Cutler et al, 2020). Participants in our study expressed similar experiences and appreciated open spaces that allowed community and activity and other spaces for withdrawal and privacy.…”

“…Participants in our study expressed similar experiences and appreciated open spaces that allowed community and activity and other spaces for withdrawal and privacy. Being able to lock their rooms and wardrobes to keep personal belongings safe from other patients is also important to patients' experience of safety (Cutler et al, 2020;Ulrich et al, 2018).…”

“…At the same time, however, patients said they felt bored, that they had to activate themselves and other patients without support from the staff, and that they lacked information about available activities. Cutler et al (2020) found that boredom among patients in acute mental health units was explained by a lack of meaningful activities, which also had a negative influence on their feelings of safety. Meaningful activities implemented as daily routines may therefore help to increase patients' feeling of safety (Cutler et al, 2020;Molin et al, 2018).…”