Racialised staff-patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data.
BMJ Ment Health
; 26(1)2023 Oct.
Article
em En
| MEDLINE
| ID: mdl-37852630
ABSTRACT
BACKGROUND:
The current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of care in National Health Service (NHS) mental health services.OBJECTIVE:
We undertook a detailed realist secondary qualitative analysis of 10 interviews in which expressions of racialisation were unexpectedly reported. This theme and these data did not form part of the primary realist evaluation.METHODS:
Interviews were originally conducted with the patients (18-65 years 40% female, 60% male) from four different geographically located NHS England mental health trusts between July and October 2017. Secondary qualitative data analysis was conducted in two phases (1) reflexive thematic analysis and retroduction; (2) refinement of context-mechanism-outcome configurations to explore the generative mechanisms underpinning processes of racialisation and revision of the initial programme theory.FINDINGS:
There were two main themes (1) absence of safe spaces to discuss racialisation which silenced and isolated patients; (2) strained communication and power imbalances shaped a process of mutual racialisation by patients and staff. Non-reporting of racialisation and discrimination elicited emotions such as feeling othered, misunderstood, disempowered and fearful.CONCLUSIONS:
The culture of silence, non-reporting and power imbalances in inpatient wards perpetuated relational racialisation and prevented authentic feedback and staff-patient rapport. CLINICAL IMPLICATIONS Racialisation in mental health trusts reflects lack of psychological safety which weakens staff-patient rapport and has implications for authentic patient engagement in feedback and quality improvement processes. Larger-scale studies are needed to investigate racialisation in the staff-patient relationships.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Saúde Mental
/
Pacientes Internados
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
BMJ Ment Health
Ano de publicação:
2023
Tipo de documento:
Article