The Relationship Between Ward Social Climate, Ward Sense of Community, and Incidents of Disruptive Behavior: A Study of a High Secure Psychiatric Sample

Puzzo, Ignazio; Aldridge-Waddon, Luke; Bush, Emma-Louise; Farr, Catherine

doi:10.1080/14999013.2018.1532972

Cited by 12 publications

(9 citation statements)

References 36 publications

(42 reference statements)

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“…Patients have reported that coercion is applied in a disproportionate way not only in terms of individual measures but to the system as a whole ( 93 ). A correlation has been found between disruptive behaviour, violence, and seclusion use in relation to sense of community and ward climate ( 109 ).…”

Section: Reducing Coercion and Restrictive Practisesmentioning

confidence: 99%

The Totalising Nature of Secure and Forensic Mental Health Services in England and Wales

Markham

2021

Front. Psychiatry

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This evidence-based opinion piece explores the totalising risk averse nature of secure and forensic mental health services and associated iatrogenic harms in England and Wales. Drawing on the research literature I consider the various influences, both external and internal which impact on the provision of such services and how both the therapeutic alliance and recovery potential for patients may be improved. Especial attention is paid to the deployment of restrictive practise, practitioner attitudes, the potential for non-thinking, and how these may impact on decision-making and the care and treatment of mentally disordered offenders.

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Section: Reducing Coercion and Restrictive Practisesmentioning

confidence: 99%

The Totalising Nature of Secure and Forensic Mental Health Services in England and Wales

Markham

2021

Front. Psychiatry

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“…Routine outcomes are used to assess effectiveness within inpatient forensic services ( 15 ). At a service level, outcome data include length of stay ( 16 ), discharge rates ( 17 ), movement between levels of security ( 15 ), frequency of inpatient violence ( 18 ), and incidents of disruptive behavior ( 19 ). At a service user level, risk assessments, such as the HCR-20v3, are used to index treatment progression ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Forensic Mental Health Services and Clinical Outcomes: A Longitudinal Study

et al. 2022

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BackgroundThe COVID-19 pandemic has had a substantial impact on forensic mental health service provision and implementation. This study aimed to provide an analysis of the impact of COVID-19 related restrictions on routine outcomes within a large forensic mental health service in London, UK.MethodWe conducted a longitudinal cohort study using data collected routinely prior to the COVID-19 pandemic (April 2018–March 2020) and then stages thereafter (March 2020–March 2021; analyzed as March–May 2020, June–September 2020, October–December 2020, January–March 2021). We used causal impact models (Bayesian structural time-series) to examine the effect of COVID-19 related changes on routine outcomes related to service provision and implementation.ResultsThere was an overall increase in long-term segregation (LTS) hours during the pandemic; 140%, (95% Cl 107, 171%) during Lockdown 1; 113%, (159% Cl 127, 192%) during post-Lockdown 1; 45% (95% Cl 23, 68%) during Lockdown 2 and, finally, 90% (95% Cl 63, 113%) during Lockdown 3. The most negative outcomes were evident during Lockdown 3. Incidents of violence were significantly more frequent during Lockdown 3 than would have been predicted based on pre-pandemic data, including physical assaults to service users (206%, 95% CI 57%, 346%), non-physical assaults to service users (206%, 95% CI 53%, 339%), and self-harm (71%, 95% CI 0.4%, 135%). Use of enforced medication also increased during Lockdown 3 (317%, 95% CI 175%, 456%).ConclusionThe pandemic and its related restrictions negatively affected some service outcomes. This resulted in increased incidents of violence and increased use of restrictive interventions, beyond what would have been expected had the pandemic not occurred.

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“…In contrast, more recent understandings have emphasised the importance of environmental factors and more specifically, their complex interactions with these patient-related factors 15 16. Thus, recent efforts to understand violence in psychiatric settings have been far more diverse in their scope, and have sought to identify how violence is influenced by (among other factors), the physical environments of wards,17 nurse and patient interpersonal styles,18 ward social climate and sense of community,19 and coercive measures 15. Perhaps most comprehensive in this respect is Cutcliffe’s and Riahi’s15 16 systemic model of variables that contribute to aggression and violence, which incorporates phenomena related to the environment, individual patients, individual clinicians and a mental healthcare system in its entirety.…”

Section: Introductionmentioning

confidence: 99%

Role of occupational therapy in reducing and managing violence among mental health inpatients: a scoping review protocol

Bell

Hallett

2021

BMJ Open

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IntroductionViolence is pervasive among psychiatric inpatients and has profound consequences for its victims, its perpetrators and mental health services. Currently, the unique contribution of occupational therapists to reducing and managing violence among this patient group has not been systematically explored. However, an a priori model which provides an initial understanding of its role in this respect can be identified from the wider scholarly literature. This scoping review aims to apply and refine this model, thereby producing an amended version that will form the basis for further research.Methods and analysisThis scoping review is based upon guidance from the Joanna Briggs Institute, Levac, Colquhoun and O’Brien’s scoping review framework, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review checklist. Electronic databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, PsycINFO, Medline, PsycARTICLES, ProQuest Health and Medicine, Allied and Complementary Medicine Database (AMED) and Google Scholar) and grey literature will be searched to identify relevant papers. Included articles will apply occupational therapy theory or occupational science to the reduction or management of violence among psychiatric inpatients and will be critically appraised by two independent reviewers. Study characteristics will be presented using frequency counts, and qualitative data will be analysed using ‘best-fit’ framework synthesis and secondary thematic analysis to produce an overall model of occupational therapy’s contribution to violence management and reduction.Ethics and disseminationResults will be disseminated through a peer-reviewed academic journal and via professional conferences. The review will collect secondary data and therefore will not require ethical approval.

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The Relationship Between Ward Social Climate, Ward Sense of Community, and Incidents of Disruptive Behavior: A Study of a High Secure Psychiatric Sample

Abstract: The relationship between ward social climate, ward sense of community and incidents of disruptive behaviour: A study of a high secure psychiatric sample

Cited by 12 publications

References 36 publications

The Totalising Nature of Secure and Forensic Mental Health Services in England and Wales

The Totalising Nature of Secure and Forensic Mental Health Services in England and Wales

The Impact of the COVID-19 Pandemic on Forensic Mental Health Services and Clinical Outcomes: A Longitudinal Study

Role of occupational therapy in reducing and managing violence among mental health inpatients: a scoping review protocol

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