Seattle University Collaborative Projects - International Academy of ...

174. Using Mental Health Legislation and Coercive Interventions:Dilemmas for Professionals and Service UsersCaring for Distressed and Disturbed Mental Health Service Users: AnExploration of Service Users and Nurses’ Experiences of Coercive InterventionsMary Chambers, St. George’s, University of London (m.chambers@sgul.kingston.ac.uk)Across Europe enhanced community care services have enabled those with mental healthproblems to remain out of hospital for longer. Admission to hospital is required only whenindividuals become very distressed and disturbed, necessitating some compulsory detention. Dueto the acuity of their illness an individual’s safety and that of others may be at risk.Consequently, health care professionals may resort to the use of coercive interventions such asrapid tranquillization, physical restraint or seclusion. Using such methods results in both clinicaland ethical dilemmas for health care staff, mainly nurses. For service users, being subjected tothese interventions can generate negative feelings. To better understand the implications of usingsuch approaches from the perspectives of both groups two separate but inter-related studies wereconducted using individual in-depth interviews with service users (n=19) in the UK and focusgroups with nurses (n=130) in acute psychiatric inpatient units in Finland, Ireland, Italy,England, Lithuania and Portugal. Findings suggest that nurses have strong negative feelingsregarding the use of coercive interventions, including fear, discomfort, apprehension,vulnerability, intimidation, and a sense of internal struggle. Service users reported lack ofpreventative techniques and therapeutic engagement, poor staff attitudes, lack of empathy and‘us versus them’ culture. The findings from these studies will be discussed in detail and theimplications for practice and education explored.Decisions and Dilemmas Surrounding the Use of Section 136 of the UK MentalHealth Act in South West LondonMirella Genziani, St George’s, University of London (mirella@arborscientiae.net)Mary Chambers, St. George’s, University of London (m.chambers@sgul.kingston.ac.uk)Steve Gillard, St George’s, University of London (sgillard@sgul.ac.uk)In the UK individuals experiencing a mental health crisis can come to the attention of police in apublic place, be issued Section 136 (S136) of the Mental Health (1983 & 2007) and taken to ahospital place of safety. Legal decisions with the potential loss of liberty are entrusted toagencies such as police and clinicians. As such, the S136 pathway is viewed as contentious andethically sensitive and less is known about stakeholders’ experiences of this process. Findingsfrom focus groups with: (i) service users; (ii) carers; (iii) mental health professionals; (iv) police;and (v) ambulance workers in a UK National Health Services Trust revealed experiences of408