‘You Still Need to Care for the patient’. Experiences of Forensic Mental Health Professionals with Inpatient Aggression

Abstract

Forensic mental health professionals are frequently exposed to inpatient aggression, which may negatively affect their physical and mental health. Current studies offer limited insight into how this may affect staff-patient interactions in the aftermath of aggression. A qualitative study was conducted to explore professionals’ experiences with exposure to aggression. Thirteen semi-structured interviews and three focus groups were conducted with 25 professionals working in a high secure forensic mental health unit. A thematic analysis was conducted in consensus among three researchers. Five main themes were generated in the analysis: exposure to different forms of aggression, factors that shape the impact of aggression, emotional reactions, managing emotional reactions, and managing relationships with patients. These themes form a complex interplay. Feelings of anger and fear, intrusive memories, and avoidant or agitated behavior toward patients are frequently reported, affecting both the personal and professional lives of participants. Interpersonal relationships between team members can promote or hinder adequate management of feelings that arise after exposure to aggressive incidents. The tremendous impact that exposure to inpatient aggression may have on professionals, and the way that they care for their patients requires more attention.