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Locked door psychiatric units have more disadvantages than advantages say staff

The disadvantages of locking the front doors of psychiatric units outnumber the advantages by more than two to one, according to a study published in the latest Journal of Clinical Nursing.

Researchers from Uppsala University in Sweden interviewed 40 mental health nurses and nursing assistants working on seven Swedish psychiatric inpatient wards with locked entrance doors.

The majority of patients in their care (45 per cent) had been diagnosed with mood disorders, 33 per cent had anxiety, personality or other disorders and 22 per cent had schizophrenia and psychotic disorders.

Eight advantages and 18 disadvantages were cited by the staff and most of these concerned patients' experiences.

"Enabling staff to control patients was felt to be an advantage by 85 per cent of staff, providing patients with secure and efficient care by 73 per cent and protection against the outside world by 68 per cent" says lead author Kristina Haglund.

"We know where the patients are" commented one member of staff, while another said that "it gives patients a sense of security when the ward is locked." Another said that family members were relieved to "know that the patient is safe and secure."

But there were twice as many disadvantages to contend with.

"The most common disadvantage, mentioned by 83 per cent of respondents, was that controlling the door was an uncomfortable and time-consuming task for staff, which could interrupt ongoing duties or contact with patients" adds Kristina Haglund.

"75 per cent felt that having a locked door could reduce patients' self-confidence and feeling of personal responsibility. "48 per cent also expressed worries that it created a non-caring environment and could make patients feel that they had to depend on staff to open the door."

One member of staff expressed concern that rattling keys could "intensity the 'prison' atmosphere" and others worried that it added "to the feel
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Contact: Annette Whibley
wordwizard@clara.co.uk
Blackwell Publishing Ltd.
24-Apr-2006


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