Safe clinical practice for patients hospitalised in mental health wards during a suicidal crisis: qualitative study of patient experiences

Abstract

AimThe aim of this study was to explore suicidal patients’ experiences of safe clinical practice during hospitalisation in mental health wards. The study was guided by the following research question: How do suicidal patients experience safe clinical practice during hospitalisation in mental health wards?Design, setting and participantsA qualitative design with semistructured individual interviews was applied. Eighteen patients hospitalised with suicidal behaviour in specialised mental health wards for adults at a Norwegian hospital participated in the study. Data were analysed thematically and inductively using qualitative content analysis.ResultsPatients in a suicidal crisis experienced safe clinical care in mental health wards characterised by the following three themes: (1) being recognised as suicidal, (2) receiving tailor-made treatment and (3) being protected by adaptive practice.ConclusionThis study illuminates the experiences of safe clinical practice for patients in a suicidal crisis. The patient group was multifaceted, with variable experiences of how safe clinical practice affected their subjective experience of safety and suicidal behaviour. The finding highlights the importance of embracing personalised activities in all parts of safe clinical practice and to recognise rather than efface patients’ variability in patient safety efforts.

Professional Care Experiences of Persons With Suicidal Ideation and Behavior: Model Development Based on a Qualitative Meta-Synthesis

“…The thoughts of suicide are perceived as unusual and incomprehensible by the people around them, sometimes leading to the humiliation of the persons with suicidal self-directed violence. Thus, many of those affected hoped that someone would notice their intentions and make small gestures without verbally expressing themselves [ 28 , 29 , 33 ]. Others tried to communicate but still required the HCPs to interpret their words and understand the severity of their suicidal ideations [ 29 ].…”

“…Thus, many of those affected hoped that someone would notice their intentions and make small gestures without verbally expressing themselves [ 28 , 29 , 33 ]. Others tried to communicate but still required the HCPs to interpret their words and understand the severity of their suicidal ideations [ 29 ].…”

“…Therefore, the included studies were classified with a recommended typology [21]. Studies were categorized as thematic surveys [24,25], conceptual or thematic descriptions [26][27][28], or interpretive explanations [29][30][31][32][33][34][35].…”

“…They received care in various health care settings, such as emergency rooms or units, day hospitals, stationary psychiatric departments of hospitals, or outpatient psychiatric settings. Data were collected through interviews in all studies [24][25][26][27][28][29][30][31][32][33][34][35] and additional observation in 2 studies [27,34]. Minors aged 11 to 17 years were interviewed in 3 studies [27,33,34].…”

Professional Care Experiences of Persons With Suicidal Ideation and Behavior: Model Development Based on a Qualitative Meta-Synthesis (Preprint)

“…It was also experienced as helpful when professional care and treatment were individualized to the needs of the affected persons [27,29,32]. Persons with suicidal ideation and behavior experienced safe clinical practice when they received tailor-made treatment.…”