Brief Treatment and Crisis Intervention Advance Access originally published online on April 9, 2008
Brief Treatment and Crisis Intervention 2008 8(3):264-273; doi:10.1093/brief-treatment/mhn007
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Unintended Impact of Psychiatric Safe Rooms in Emergency Departments: The Experiences of Suicidal Males With Substance Use Disorders
From the Centre for Addiction and Mental Health (Strike, Rufo) and the St. Michael's Hospital (Spence, Links, Bergmans, Ball, Rhodes, Watson, Enyan)
Contact author: Carol Strike, Research Scientist, Centre for Addiction and Mental Health, 33 Russell Street, T309, Toronto, ON, M5S 2S1. E-mail: carol_strike{at}camh.net.
In general hospital emergency departments (EDs), management of psychiatric crises is challenging. We analyzed issues related to use of psychiatric assessment rooms using semi-structured interviews with adult, male, suicidal ED patients, and ED staff (physicians, nurses, and others). An iterative, thematic analytic process was employed. Although ED psychiatric assessment rooms were designed to provide a safe and therapeutic environment, participants held negative attitudes about the physical attributes and the emotional responses to these rooms. Many patients presented at the ED because they were alone, scared, and lacking social supports, but felt punished when assigned to a psychiatric room. Physical separation and observation were said to escalate symptoms leading participants to question the therapeutic value of the rooms. Although believed to be in the best interest of patients and staff, these rooms may have an unintended negative impact.
KEY WORDS: seclusion, psychiatric assessment rooms, suicide, emergency department, males