McKeown, M, Thomson, G, Scholes, A et al. (7 more authors) (2020) Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study. Sociology of Health & Illness, 42 (3). pp. 449-464. ISSN 0141-9889
Abstract
Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the ‘REsTRAIN Yourself’ (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma‐informed care represents a potentially alternative legitimacy.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 Foundation for the Sociology of Health & Illness. This is the peer reviewed version of the following article: McKeown, M., Thomson, G., Scholes, A., Jones, F., Downe, S., Price, O., Baker, J., Greenwood, P., Whittington, R. and Duxbury, J. (2020), Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study. Sociol Health Illn, 42: 449-464. doi:10.1111/1467-9566.13015, which has been published in final form at https://doi.org/10.1111/1467-9566.13015. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | nursing; nurse–patient communication/interaction; violence; materialities; ethnography |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Mental Health (Leeds) |
Funding Information: | Funder Grant number Health Foundation 7263 |
Depositing User: | Symplectic Publications |
Date Deposited: | 18 Sep 2019 09:35 |
Last Modified: | 27 Oct 2020 01:38 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/1467-9566.13015 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:150941 |