De-escalation a social and collaborative process in mental health care settings: workshop

Title

De-escalation a social and collaborative process in mental health care settings

Background

Coping with and understanding violent and threatening behaviour in mental health care settings is a challenging, but integral part of a caregiver’s job. If not handled well, such situations can result in staff and patient injuries, and they can lead to stereotype representations of patients as divergent, unpredictable and dangerous. Therefor there is a need to avoid violence and implement de-escalation approaches.

Aim

This interactional workshop discusses and reflects upon how sustainable de-escalation practices can be implemented in mental health care settings and to how increased knowledge about de-escalation can create safe settings and reduce violence and use of coercive measures.

Methods

The workshop includes a presentation of how four studies contributed in developing a de-escalation strategy: 1) an integrative literature review on de-escalation, 2) a critical discourse analysis, examining how mental health workers constructs accounts of aggressive events, 3) a multiple case study, exploring threatening and violent situations resolved without the use of coercive measures, and 4) a co-operative inquiry that investigated how practical knowledge about de-escalation was achieved and transformed in a psychiatric intensive care unit. The research methods used were ethnographic, including focus group interviews, participant observation ethnographic field notes and our process notes and summaries.

Findings
The workshop exemplifies the study findings such as how mental health workers in collaboration with each other, generated knowledge about how to break the vicious circle, and instead help the patients to solve the problem by means of a structured de-escalation process including two phases: The acute phase (crisis) and the re-establishing trustworthiness phase. They transformed this knowledge through role-play in action learning sessions and they developed a sustainable learning program which included the patients as active participants.
Conclusion
A social and collaborative understanding of de-escalation practises can foster shared problem solving in violent and threatening situations. This approach offers a turning point in violence management: instead of blaming each other, members of staff will look at their experiences with curiosity. They lift de-escalation to a professional level where they understand their experiences theoretically and thus become aware of avoiding power struggles.

The workshop contains:
• A short introduction to the de-escalation strategy and the research behind
• Implementing de-escalation - challenges
• A presentation of the learning program
• Participants is divided into groups. Each group discuss the de-escalation strategy and the transferability.

Learning outcome
• The participants will reflect upon de-escalation and a social and changeable process
• The participants will discuss the evidence behind de-escalation
• The participants will reflect upon essential de-escalation skills