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Staff’s understanding of the role of least restrictive practice in the development of obesity in secure psychiatric inpatients

Anna Lloyd (Department of Nutrition and Dietetics, St Andrew’s Healthcare Birmingham, Birmingham, UK and Department of Psychology (School of Social Sciences), Birmingham City University, Birmingham, UK)
Joseph Lloyd Davies (Department of Applied Psychology, School of Sport and Health Sciences Cardiff Metropolitan University, Cardiff, UK)
Rebecca Semmens-Wheeler (Faculty of Business Law and Social Sciences, Birmingham City University, Birmingham, UK)
Ali Isa Alfaraj (St Andrew's Healthcare Birmingham, Birmingham, UK)
Domingo Gonzalez Naranjo (St Andrew's Healthcare Birmingham, Birmingham, UK)
Kieran Breen (Department of Research, St Andrew's Healthcare, Northampton, UK)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 10 October 2024

Issue publication date: 12 November 2024

19

Abstract

Purpose

This study aims to explore the ethical challenges of managing the weight of psychiatric patients in the least restrictive manner in secure mental health settings and whether these could be considered as a source of moral distress for health practitioners, which may be linked to staff burnout and ultimately lead to suboptimal patient care.

Design/methodology/approach

A qualitative semi-structured interview study design was used to explore the understanding, views and experiences of six staff members working on two medium-secure wards in a UK mental health hospital using an opportunity sampling technique and Interpretative Phenomenological Analysis.

Findings

Analysis of semi-structured interviews revealed a multitude of moral events that evoked feelings of frustration, powerlessness and anxiety related to the management of obesity in the least restrictive way, which is indicative of moral distress.

Research limitations/implications

Due to the small sample size and the qualitative nature of the research, the findings of this study are of explorative in nature. Further quantitative research would be required to establish a causative link between the ethical challenges associated with obesity management and staff’s moral distress.

Practical implications

Addressing the health-care professionals’ knowledge deficit on how to achieve the right balance in their duty of care through inclusion of bioethics into professional discussions and training could improve staff’s well-being and the organisation’s ethical climate.

Originality/value

To the best of the authors’ knowledge, this is the first qualitative work exploring the role of least restrictive practice in the challenges associated with health promotion within secure psychiatric settings, and the effect these challenges have on mental health staff.

Keywords

Acknowledgements

The primary author would like to express sincere gratitude to the academic supervisor, Dr Rebecca Semmons-Wheeler, and the colleagues, Dr Alfaraj, Dr Naranjo and Dr Breen for clinical supervision and supporting the ethical approval and recruitment process. The primary author thanks Dr Joseph Lloyd Davies for helping with the publication process and her other colleagues for participating and making this academic project a rewarding experience.

Citation

Lloyd, A., Davies, J.L., Semmens-Wheeler, R., Alfaraj, A.I., Naranjo, D.G. and Breen, K. (2024), "Staff’s understanding of the role of least restrictive practice in the development of obesity in secure psychiatric inpatients", The Journal of Mental Health Training, Education and Practice, Vol. 19 No. 6, pp. 305-314. https://doi.org/10.1108/JMHTEP-08-2023-0076

Publisher

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Emerald Publishing Limited

Copyright © 2024, Emerald Publishing Limited

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