Journal article
Perspectives and Experiences of People Receiving Care on a De‐escalation Intervention to Reduce Restrictive Practices in Acute Mental Health Units
International journal of mental health nursing, Vol.35(4), pp.1-16
08/2026
PMID: 42370744
Appears in Recent Faculty of Health Publications
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Abstract
Interventions aimed at reducing restrictive practices are also designed to enhance the service experience in acute mental health units. However, people with experience of coercive engagement with these services are seldom involved as active contributors in evaluative research on interventions to reduce restrictive practices. With the meaningful involvement of lived experience practitioners, this research was aimed at examining care recipients' service experiences and perspectives on nurses' therapeutic responses during the implementation of a de‐escalation intervention in three adult inpatient units within New South Wales, Australia, from March 2024 to April 2025. Nested within a larger study employing a mixed concurrent control design, this research evaluated the effectiveness and process of the Safe Steps for De‐escalation through comparisons of unmatched measures of empowerment, dehumanisation, and staff actions on violence prevention across three time points, as well as through a reflective thematic analysis of semi‐structured interviews. Safe Steps is a structured approach for therapeutic responding, targeting nurses' relationship‐promotion behaviours to increase focus on minimising the use of restrictive practices. Eighty‐six inpatients completed the unmatched measures, with nine participating in interviews following discharge. No significant changes were noted in quantitative measures over time. Five themes emerged from the qualitative analysis: (i) Clarity calms; confusion harms, (ii) Control cuts deep, (iii) Systems strain; people break, (iv) Connection is treatment in itself, and (v) Meaning‐making outweighs medicine. These findings cast acute inpatient units in a light akin to a power circuit, elevating the need to make inpatient admissions more reflective of everyday life outside the units.
Details
- Title
- Perspectives and Experiences of People Receiving Care on a De‐escalation Intervention to Reduce Restrictive Practices in Acute Mental Health Units
- Creators
- Esario IV Daguman - Southern Cross UniversityDane Owen - Coffs Harbour Base Hospital (NSW, Coffs Harbour)Jacqui Yoxall - Southern Cross UniversityRichard Lakeman - Southern Cross UniversityMarie Hutchinson - Southern Cross University
- Publication Details
- International journal of mental health nursing, Vol.35(4), pp.1-16
- Publisher
- Wiley
- Grant note
- This research is part of a larger study supported by Southern Cross University and the Translational Research Grant Scheme from the NSW Office for Health and Medical Research. Open access publishing facilitated by Southern Cross University, as part of the Wiley - Southern Cross University agreement via the Council of Australasian University Librarians.
- Identifiers
- 991013387152602368
- Copyright
- © 2026 The Author(s).
- Academic Unit
- Office of the Vice Chancellor; Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article