Ms Jacinta Chavulak1, A/Prof Melissa Petrakis, Mr Terry Smyth, Mr Nicholas Sutcliffe
1Eastern Health/Monash University, Box Hill/Caulfield East, Australia
Biography:
Jacinta Chavulak is a qualified social worker based in Melbourne, Australia. She is currently working as a senior mental health social work educator and university teaching associate. She is also currently undertaking her PhD. Her direct practice experience includes senior clinician positions in areas such as Emergency Psychiatry, suicide prevention, clinical case management, support work and community work. Her research work is focused on preserving human rights and access in service delivery. She has published on potential alternatives to seclusion and restraint in public acute inpatient mental health services, peer workforce development and service access for care leavers.
Abstract:
Purpose:
Internationally, consumers and their families have raised concerns about safety in current mental health service delivery. Underfunding and risk-averse management practices are implicated as key challenges. Despite allied health clinicians' working in crisis teams, Australian and International research does not include views from this cohort. This study aimed to explore initial clinician perspectives on needed changes to reduce restrictive interventions and to improve conditions for service users and staff alike and highlight the allied health role as mental health clinicians.
Methods:
Utilizing a co-operative inquiry approach, this unique study was clinician-led and co-produced by researchers and clinicians. Community and Emergency Department Crisis Mental Health Clinicians (social work and nursing) explored their use of restrictive interventions, and what they need from policy and resources to change practices. Clinician-researchers collected data across two meetings, subsequently co-conducted a thematic analysis of their reflections in a group setting, and co- produced the write up and reflections of the results.
Results:
Seven themes were developed which explored: the holding of risk; over interventions, imperfect solutions; containment seeking; time’s importance in the holding of risk; least restrictive environments; and holding risk as an isolating practice. These themes are presented as questions that arose through these discussions, as clinician- researchers reflected on their own practice.
Discussion:
The environments where crisis clinicians work are not designed for least restrictive practice, despite these clinicians often find creative and thoughtful solutions to imperfect circumstances.
Conclusion:
Future research is planned and will be reported on.