What evidence supports the use of Body Worn Cameras in mental health inpatient wards? A systematic review and narrative synthesis of the effects of Body Worn Cameras in public sector services.
Keiran Wilson, Jessica Eaton, Una Foye and 3 others
PMID 34877792WHAT IT FOUND
There is no generalisable evidence that body worn cameras reduce patient violence against staff in mental health wards.
Existing mental health studies are low quality and show mixed results, with some wards reporting increased verbal abuse and violence alongside decreases in restraint.
Key findings
01The review found no generalisable research supporting the use of body worn cameras to reduce patient violence against staff, which is the primary motivation for their implementation in mental health settings.
02In the two mental health studies included, results were mixed: one reported increases in verbal abuse and violence on three wards but decreases in violence and restraint on others, while the second found a non-significant decrease in incidents overall but significant changes in incident seriousness on acute wards.
03Patient perspectives on cameras were divided; some felt cameras made staff more confident and safer, while others reported that being observed caused irritability and anger.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence base is dominated by law enforcement studies (43 of 52), which are not directly applicable to mental health inpatient settings due to different environmental and relational contexts. Only two studies specifically examined mental health settings, and both were small-scale pilots with mixed results. 30 of the 52 included studies were rated as poor quality with a high risk of bias. Both mental health studies received cameras free of charge from manufacturers, which introduces potential conflict of interest and bias in reporting. There is a lack of economic analysis and patient perspective data in the wider evidence base.
Declared interests
The review notes that five studies, including both of the mental health studies, received camera equipment free of charge from companies. One lead author had expenses reimbursed by the camera company. The review itself was registered with PROSPERO, and no specific funding source for the review authors is detailed in the provided text, but the reliance on industry-supplied equipment in the underlying evidence is highlighted as a bias risk.
The easy way to misread this
Do not interpret the mixed results from police or transport sectors as evidence that body worn cameras will work in mental health wards. The mental health-specific evidence is limited, low-quality, and shows that while some forms of restraint may decrease, verbal abuse and low-level violence may increase, and patient trust may be compromised.