Support after coercive practice: perspectives of mental health service users, carers and staff.

Introduction:

Coercive practices (CP), such as physical restraint, are common mental healthcare practices. Yet their use is controversial due to associations with physical and psychological harms in service users and staff. Furthermore, there is evidence of health inequalities in use of CP with certain groups, for example, people from Black and racially minoritised backgrounds, more often subject to CP during contacts with mental health service.



To prevent harm, healthcare guidelines recommend holding post-incident reviews or debriefs with service users and staff after an incident of CP (National Institute for Health and Care Excellence [NICE], 2015). However, evidence, including from groups more often exposed to CP (e.g. people from Black and racially minoritised groups), to suggest what makes these discussions helpful for service users or staff and how this intervention should be delivered in mental health wards is limited.



This study aims to address this research gap by exploring lived experience views of mental health service users, informal carers, and staff, who have experience of CP in mental health wards, on CP and how to improve experiences for service users and informal carers who have been exposed to CP.

 

Methods:

Individual semi-structured audio recorded interviews undertaken with mental health service users, informal carers, and staff stakeholders. Interview data subject to framework analysis to elucidate convergence and divergence of perspectives across stakeholder groups.  

 

Results and Discussion:

Preliminary themes: ‘owning narratives’, incident narratives always from staff perspectives; trauma, CP as traumatic with lasting impacts, and ‘right support, right time’, distinction between immediate practical and emotional support on the ward and a later space to process the experience. Key themes as they relate to use and impacts of CP in mental health services, availability and quality of support, and improving service user and carer experiences will be discussed with reference to the broader literature.