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Exploring behaviours of concern including aggression, self-harm, sexual harm and absconding within an Australian inpatient mental health service
- Source :
- Australasian Psychiatry. 28:394-400
- Publication Year :
- 2020
- Publisher :
- SAGE Publications, 2020.
-
Abstract
- Objective: Patients admitted to mental health services may exhibit behaviours of concern (BOCs) such as aggression, self-harm, absconding and sexual harm. BOCs can lead to restrictive interventions, which have adverse effects on patients, carers and staff. This paper aims to explore the nature and outcome of BOCs within an adult inpatient mental health setting. Methods: A retrospective audit was conducted at a metropolitan inpatient service between 1 August 2016 and 31 July 2017. The frequency, nature and outcomes of BOC episodes were described and thematic analysis was used to summarise BOC antecedents. Results: A BOC was documented for 179 (18.2%) patients who also showed high rates of drug abuse, homelessness and longer admission. Most self-harm and sexual harm events occurred outside of normal business hours. Medications and verbal de-escalation were commonly used interventions. Episodes of deliberate self-harm were likely to result in patient and staff injury or mechanical restraint, whereas aggression was associated with seclusion. Mental state, care engagement, physiological stress and situational stressor were identified as BOC antecedents. Conclusion: Multiple forms of BOCs were experienced with mental state, physical and interpersonal contributors identified. Improving multidisciplinary input into early assessment and treatment of BOC causes is needed to improve safety.
- Subjects :
- Adult
Male
medicine.medical_specialty
Sexual Behavior
Mental health service
03 medical and health sciences
0302 clinical medicine
Escape Reaction
medicine
Humans
030212 general & internal medicine
Psychiatry
Retrospective Studies
Inpatients
Clinical Audit
Aggression
Mental Disorders
Australia
Restrictive interventions
Middle Aged
Mental health
030227 psychiatry
Psychiatry and Mental health
Harm
Deliberate self-harm
Female
medicine.symptom
Risk assessment
Psychology
Self-Injurious Behavior
Subjects
Details
- ISSN :
- 14401665 and 10398562
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Australasian Psychiatry
- Accession number :
- edsair.doi.dedup.....4fed22699fdc0ca7e37e9a614e0bc202