[NYAPRS Enews] Study: Self Harm And Violence More Likely In 'Locked Up' Psych Units

[Matt Canuteson]

Self Harm And Violence Towards Nursing Staff More Likely In Locked Up
Mental Health Patients

Nursing Times December 8 2008

 

Mental health patients who are locked in acute psychiatric wards are
significantly more likely to engage in self harm and violence towards
nursing staff than those who are not confined, UK nurse researchers have
found.

 

Operating a 'locked door' policy is intended to promote safety by
preventing patients from absconding and harming themselves or others.

 

Yet locking the doors actually increases the risk of self harm and
violently attacks on nursing staff and other patients, said the team
from the mental health department at City University London.

 

In one of the largest UK studies into exit security measures on mental
health wards, the researchers studied over 50,000 responses from
questionnaires and interviews with staff, patients and visitors from 130
of the 500 acute psychiatric wards in England.

They found that a 'locked door' policy led to patients feeling
frustrated, stigmatized and depressed. It increased the risk of physical
violence to others by 11% and self-harm by 20%, the researchers said.

They also found that 22% of patients in locked wards are more likely to
refuse medication.

 

Lead researcher Len Bowers, professor of psychiatric nursing at City
University London, said that less security was needed on mental health
wards rather than more.

 

'The findings quite clearly demonstrate that locking doors is a highly
imperfect strategy,' he said, presenting the findings at the annual
Eileen Skellern lecture at London South Bank University last week.

 

He added: 'There are better ways of keeping people safe and preventing
them from absconding and we need to be clever about finding these.'

 

Ian Hulatt, RCN mental health adviser, said: 'This research provides
empirical evidence that locking patients in wards makes them feel
unhelped and unhappy. [Previous] research shows that engaging patients
in meaningful activity reduces levels of absconding and 

self-harming.

 

'But nurses working in this acute specialty need the support and ongoing
education to help improve outcomes, and ward design and staffing levels
also need to be considered.'

 

http://www.nursingtimes.net/clinicalnews/2008/12/self_harm_and_violence_
towards_nursing_staff_more_likely_in_locked_up_mental_he.html

 

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