Developing Safewards Secure for Mental Health Prison Units Using a Nominal Group Technique.

Area of Science:

• Forensic mental health nursing
• Correctional healthcare
• Conflict resolution in secure settings

Background:

• Safewards model successfully reduces conflict and containment in general mental health units.
• Adaptations of Safewards exist for secure forensic mental health services.
• Forensic mental health nurses in prison settings require tailored models for conflict and containment reduction.

Purpose of the Study:

• To develop an adapted version of the Safewards model for nurses in bed-based prison mental health units.
• To identify unique features, flashpoints, and staff/consumer modifiers relevant to the prison context.
• To achieve consensus on necessary modifications for a secure-custodial mental health setting.

Main Methods:

• Literature review to identify contextual features of prison mental health units.
• Nominal Group Technique (NGT) with multidisciplinary staff (n=12) from bed-based prison mental health units.
• Thematic analysis of qualitative data to interpret findings and reach consensus on model adaptations.

Main Results:

• Identified a significant divergence between custodial and forensic mental health staff values and objectives ('Square peg, round hole').
• Highlighted the critical need for custodial staff support in implementing any new model.
• Achieved consensus on all proposed changes and additions to the Safewards model for this setting.

Conclusions:

• An adapted Safewards model, named Safewards Secure-Custodial Mental Health, is needed for prison mental health nurses.
• Further development of modifiers specifically for custodial staff is essential.
• Successful implementation necessitates close collaboration with correctional services.