Abstract
BackgroundStaff-directed aggression is a concern for service providers in mental healthcare, frequently affecting both the quality of services and staff wellbeing. This also applies to supported housing services for people with mental health problems. Staff themselves consider training to be an important route to improve the prevention and management of staff-directed aggression. The aims of this study are to explore how staff in community mental health supported housing services conceptualize practice in prevention and management of aggression and how these conceptions develop following a local education and training endeavor in disempowerment-sensitive, de-escalating and knowledge-based risk assessment and management.MethodPhenomenography, a qualitative research approach, was adopted to pursue the study aims. The data consisted of 26 semi-structured interviews with 13 participants from five different municipal housing facilities in Oslo, Norway. Participants were interviewed on two occasions, once prior to participation and once subsequent to the finalization of the education and training sessions.ResultsThe analysis led to the development of six qualitatively different, yet logically interrelated, categories of description regarding practice in encounters with staff-directed aggression: (1) Observation, alertness and awareness, (2) Established understanding and knowledge of service users, (3) Team-based risk management and deliberation, (4) Adaption of own dispositions and behaviors, (5) Reflexivity, sensitivity and care and (6) Involvement and dialogue. These conceptions were found to vary in meaning and focus; they ranged from implementing safeguarding and protective measures, to drawing on what was portrayed in terms of staff’s expert knowledge, to increasingly allowing for, and committing to, tenant perspectives in designing practice. The results indicate a moderate, yet beneficial, effect of the course on conceptual change in the participants.ConclusionThis study shows that practice in encounters with staff-directed aggression is conceptualized as complex and multifaceted by staff in mental health supported housing services and that the various conceptions have different implications for the way staff-directed aggression is mitigated individually and collectively. Our findings also suggest that it is beneficial to take conceptual variation regarding practice into consideration when devising education and training aimed at enhancing staff knowledge, skills and practices.
Highlights
Staff-directed aggression is a concern for service providers in mental healthcare, frequently affect‐ ing both the quality of services and staff wellbeing
The analysis led to the development of six qualitatively different, yet logically interrelated, categories of description regarding practice in encounters with staff-directed aggression: (1) Observation, alertness and awareness, (2) Established understanding and knowledge of service users, (3) Team-based risk management and deliberation, (4) Adaption of own dispositions and behaviors, (5) Reflexivity, sensitivity and care and (6) Involvement and dialogue
This study shows that practice in encounters with staff-directed aggression is conceptualized as com‐ plex and multifaceted by staff in mental health supported housing services and that the various conceptions have different implications for the way staff-directed aggression is mitigated individually and collectively
Summary
Staff-directed aggression is a concern for service providers in mental healthcare, frequently affect‐ ing both the quality of services and staff wellbeing This applies to supported housing services for people with mental health problems. The context of this study is supported housing services based on type 1 in the Simple Taxonomy for Supported Accommodation (STAX-SA) [4]: (a) staff on-site, (b) high support, (c) limited emphasis on moving on, and (d) a congregate setting As this bears some resemblance to inpatient settings, community supported housing has been claimed to carry the risk of adopting ‘institution-like’ qualities [5], despite the initial intention to promote ‘normality’ and social inclusion of tenants. Dyb [5] further suggests that the organization of the services, and whether the staff mainly understand their work in terms of providing institutional or home-based care, affect whether tenants experience their living situation as resembling an institution or a home
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
