Abstract
Background: Inpatient mental health wards are reported by many consumers to be custodial, unsafe, and lacking in therapeutic relationships. These consumer experiences are concerning, given international policy directives requiring recovery-oriented practice. Safewards is both a model and a suite of interventions designed to improve safety for consumers and staff. Positive results in reducing seclusion have been reported. However, the voice of consumers has been absent from the literature regarding Safewards in practice. Aim: To describe the impact of Safewards on consumer experiences of inpatient mental health services. Method: A postintervention survey was conducted with 72 consumers in 10 inpatient mental health wards 9–12 months after Safewards was implemented. Results: Quantitative data showed that participants felt more positive about their experience of an inpatient unit, safer, and more connected with nursing staff. Participants reported that the impact of verbal and physical aggression had reduced because of Safewards. Qualitatively, participants reported increased respect, hope, sense of community, and safety and reduced feelings of isolation. Some participants raised concerns about the language and intention of some interventions being condescending. Discussion: Consumers’ responses to Safewards were positive, highlighting numerous improvements of importance to consumers since its implementation across a range of ward types. The findings suggest that Safewards offers a pathway to reducing restrictive interventions and enables a move toward recovery-oriented practice.
Highlights
In the contemporary Australian mental health service system, acute inpatient wards are challenging settings where a high proportion of consumers are involuntarily admitted, for example, in the years 2016–2017, 57% of Victorian inpatient admissions were involuntary [1]
Most participants were positive about Safewards, highlighting important improvements in their experiences of inpatient care since implementation
The key themes arising from the qualitative data highlight the alignment between the impact of Safewards interventions and recoveryoriented practice, which is highly valued by consumers
Summary
In the contemporary Australian mental health service system, acute inpatient wards are challenging settings where a high proportion of consumers are involuntarily admitted, for example, in the years 2016–2017, 57% of Victorian inpatient admissions were involuntary [1]. Internationally, consumers report a myriad of harmful experiences during their inpatient care [2], many associated with restrictive practices. Such harms may be a contributing factor to suicides both during and after admission [3, 4]. Inpatient mental health wards are reported by many consumers to be custodial, unsafe, and lacking in therapeutic relationships. These consumer experiences are concerning, given international policy directives requiring recoveryoriented practice. Safewards is both a model and a suite of interventions designed to improve safety for consumers and staff. The voice of consumers has been absent from the literature regarding Safewards in practice
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