Forensic mental health service users explain staff behaviours that trigger challenging behaviour

Positive behavioural support: unit's staff now more aware of service users' sensitivities

Staff at a forensic mental health intensive care unit have learned to curb behaviour such as whispering among themselves, which can trigger aggressive responses in service users.

Service users and staff worked together to develop the positive behavioural support framework, which aims to prevent and manage challenging behaviour at the unit, run by Abertawe Bro-Morgannwg University Health Board in south Wales.

Staff and service users worked together

Unit service users have a range of challenging behaviours, including verbal aggression, violence and self-harm.

A nurse interviewed service users and colleagues to gain an insight into a variety of factors that could contribute to distress on the unit.

• RELATED: Implementing positive behavioural support in a forensic psychiatric intensive care unit: addressing the barriers

A community mental health nurse for the board Jamie Hughes, told delegates at the RCN international mental health nursing research conference in Manchester that staff and service users were able to identify triggers for challenging behaviour, primary and secondary prevention strategies and crisis management interventions.

'We need sensitivity and optimism'

Service users said staff whispering, laughing or joking with each other could contribute to individuals' paranoia and they asked staff to be sensitive of service users' experience of being detained. This would mean avoiding expressions such as 'wanting to get out of here’ at the end of shift, or discussing their weekend.

They also wanted optimistic conversations about the future, and asked that staff adopted a calm and confident manner.

Themes from this feedback were developed into a poster that was displayed on the ward.

Mr Hughes said staff had seen a significant reduction in challenging behaviour since implementing the framework on the ward and the poster is now being used in other parts of the board to raise awareness of the positive behavioural support framework.

Read more

Poster – developing a ward based ethos based on positive behavioural support 

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