Restriction and Control: The Perceptions of Mental Health Nurses in a UK Acute Inpatient Setting

In the United Kingdom there has been growing unease over standards of care and treatment in acute inpatient psychiatric services. Although recent reforms have declared nurses as pivotal to the social transformation required, few accounts inform modernisers about the reality of social systems, relations, and events in modern acute psychiatric services. This qualitative study explores the situation of nurses working in acute inpatient psychiatric services. It particularly describes the social control elements that continue to influence working norms. Five nurses were interviewed and texts of these interviews were transcribed and analysed using content analysis. As a further source of data, documents were interpreted to illuminate social mechanisms. Issues of objectivity, validity, and reliability were considered throughout. Ethical issues were considered throughout and approval for the study was gained from the appropriate Research Ethics Committee. Social control functions portrayed by day-to-day rituals and operating norms emerged as a central theme in the findings. Social control is a prominent working norm. This is described through activities of observation, surveillance, and managing "difficult" behaviours. Therapeutic relationships present as a paradox to the control assumed. Implications of these findings are discussed.