Exploring How the Psychological Safety of Patients Is Impacted by Restrictive Practices in Inpatient Mental Healthcare: A Qualitative Study.
Bethany Griffin, Judith Johnson, Katharina Sophie Vogt and 3 others
PMID 41159604WHAT IT FOUND
Eighteen former inpatients described restrictive practices as psychologically unsafe when staff reacted to behaviour without exploring why, used locked doors and blanket restrictions, or left them without debrief.
Clear communication and small choices could improve safety.
Key findings
01Participants felt less psychologically safe when staff used restraint or observations without exploring why the behaviour happened.
02Locked doors, blanket restrictions and inconsistent ward rules made participants feel trapped, controlled and unsafe.
03Witnessing restrictive practices and poor communication upset participants, while individualised communication supported psychological safety.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Volunteer sampling may have attracted people with more negative experiences. Participants were interviewed after discharge, sometimes long after their stay, so memory may be imperfect. The sample was small and mostly female and White-British, so it may not represent all former inpatients. Half of the participants had worked in health or social care, which may shape how they described care. The study reports themes, not whether any intervention works or how often restrictive practices cause harm.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these themes as proof that restrictive practices cause lasting psychological harm or that ward changes will prevent harm. The study describes 18 former patients' experiences, many recruited by volunteering and interviewed long after discharge, so it cannot show cause or how common these experiences are.