Facilitating a safe and caring atmosphere in everyday life in forensic mental health wards - a qualitative study

Abstract

Purpose: To explore healthcare professionals’ experiences with facilitating a safe and caring atmosphere in patients’ everyday lives in forensic mental health wards.

Methods: This qualitative study employed interviews with 16 healthcare professionals working shifts in two forensic mental healthcare wards in Norway. Data were analysed using phenomenological hermeneutic analysis.

Results: The findings are presented in terms of two themes. The first theme is “Creating a calming atmosphere” and includes the subthemes “Creating caring surroundings with safety, comfort and trust” and “Balancing everyday life activities”. The second theme is “Facilitating risk assessments and care” and includes the subthemes “Acting as a team”, “Becoming aware of the meaning in signs” and “Becoming aware of vulnerability and the window of tolerance”.

Conclusions: Involvement in patients’ history and lived lives is important both for understanding general social behaviour as well as for assessing signs, symptoms, and changes in patients’ conditions; furthermore, it provides valuable information that allows healthcare professionals to become aware of the underlying meanings in signs, which can facilitate examinations and treatment. Acting as a team is essential to solve issues in a calm and safe way when signs of violence occur. In addition, our participants highlighted the need to be aware of individual patients’ vulnerability and windows of tolerance to obtain a deeper understanding of patients’ lived lives as a whole in the context of providing therapy and care to patients.