Staff Perspectives in Mental Health Research Regarding Restrictive Interventions: An Australian Scoping Review and Thematic Analysis

Author:

Chavulak Jacinta12ORCID,Smyth Terry2,Sutcliffe Nicholas2,Petrakis Melissa13ORCID

Affiliation:

1. Social Work Department, School of Primary and Allied Health Care, Caulfield Campus, Monash University, Caulfield East 3145, Australia

2. Mental Health Service, Alfred Health, Melbourne 3004, Australia

3. Mental Health Service, St Vincent’s Hospital Melbourne, Fitzroy 3065, Australia

Abstract

Service users and their families have raised concerns about safety in current acute mental health service delivery. Restrictive interventions are routinely used across mental health settings despite increasing awareness of the negative impacts. Underfunding and risk-averse management practices are implicated as key challenges. Utilizing a scoping review and thematic analysis method, this review explored the existing literature of mental health staff perspectives across various settings (including psychiatric wards and emergency departments), focusing on their experience of restrictive interventions. Four themes were developed: 1. Safety (both staff and patient); 2. Barriers to staff reducing their restrictive interventions; 3. Strength in current practice; 4. Recommendations for change. Key gaps in the literature were the limited perspectives of emergency and crisis clinicians (despite these areas being settings where restrictive interventions are utilized) and limited perspectives from allied health disciplines (despite their employment as clinicians in these settings). It also noted a divide between staff and patient safety, as though these concerns are mutually exclusive rather than cooccurring, which is the experienced reality. Advocacy bodies, governments and the media are calling for a reduction in restrictive interventions in crisis settings. This research synthesis proposes that, to achieve this, clinical staff must be involved in the process and their perspectives actively sought and drawn upon to enable reform.

Publisher

MDPI AG

Subject

Behavioral Neuroscience,General Psychology,Genetics,Development,Ecology, Evolution, Behavior and Systematics

Reference29 articles.

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