Staff support procedures in a low-secure forensic service

Pages191-201
DOIhttps://doi.org/10.1108/JFP-09-2017-0034
Date13 August 2018
Published date13 August 2018
AuthorSarah Cooper,Andy Colin Inett
Subject MatterHealth & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice
Staff support procedures in a low-secure
forensic service
Sarah Cooper and Andy Colin Inett
Abstract
Purpose Staff working in forensic inpatient settings are at increased risk of harm perpetrated by patients.
Support offered in response to such incidents can have a significant impact on how staff recover.
The purpose of this paper is to explore how staff support procedures implemented in one low-secure forensic
service impacted on staff recovery.
Design/methodology/approach In total, 11 members of staff who had direct patient contact volunteered
from an opportunity sample. Semi-structured interviews were conducted with each participant, asking about
experiences of abuse at work and subsequent staff support procedures. Interviews were analysed using
thematic analysis.
Findings Four overarching themes were identified; experiences of harm, supported recovery, missed
opportunities and therapeutic relationships. This led to a better understanding of how staff coped with
incidents of abuse at work and how support procedures impacted on their recovery.
Research limitations/implications The service evaluation was limited by transferability of the findings.
The process of sampling may have meant there were biases in those who volunteered to take part. Further
projects such as this are required to develop the themes identified.
Practical implications Findings led to the development of a new integrated model of staff support.
Originality/value This was one of the first studies in the UK to formally evaluate a staff support procedure
in forensic low-secure services and include experiences of both clinical and non-clinical staff who are regularly
exposed to potentially harmful events.
Keywords Resilience, Forensic inpatient, Low-secure, Model of support, Patient violence, Staff stress
Paper type Research paper
Introduction
UK studies have revealed staff on inpatient units are at most risk of violence and aggression in
healthcare settings (Renwick et al., 2016).The National Audit of Violence foundon acute inpatient
settings 44per cent of clinical staff and 72 per cent of nursing staffwere threatened or made to feel
unsafe at work; 46 per cent of nursing staff reported physical assaults (Royal College of
Psychiatrists,2007). Bowers et al. (2011) found rates of violencewere greater in forensic inpatient
services.Variations of violence withinsettings exist and may be accountedfor by staffing levelsand
education (Bowers et al., 2005); as well as methodological problems in study design (Beechand
Leather, 2006).Violence experienced byhealthcare staff takes many formsincluding, verbal abuse
and threats (Jonker et al., 2008), physical assaults (Renwick et al., 2016) and sexual assaults
(Flannery et al.,2011).
Impact of patient perpetrated violence
Consequences to these events can include physical injury (Bowers et al., 2011) and/or
psychological harm (Leeuwen and Harte, 2015). In the UK, a study of 150 forensic healthcare
professionals working in mental health and learning disability services, Elliott and Daley (2012)
found a substantial proportion of staff experienced elevated levels of psychological distress and
occupational stress, with moderate levels of burnout, their relatively small sample size and low
response rate may have impacted on results. Whilst the majority of staff go on to make full
Received 4 September 2017
Revised 6 November 2017
19 December 2017
Accepted 24 December 2017
Sarah Cooper is a Forensic
Psychologist in Training at the
Kent and Medway NHS and
Social Care Partnership Trust,
Dartford, UK.
Andy Colin Inett is a Consultant
Forensic Psychologist
at the Tarentfort Centre,
Dartford, UK.
DOI 10.1108/JFP-09-2017-0034 VOL. 20 NO. 3 2018, pp. 191-201, © Emerald Publishing Limited, ISSN 2050-8794
j
JOURNAL OF FORENSIC PRACTICE
j
PAG E 19 1

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