Exploring behaviours of concern including aggression, self-harm, sexual harm and absconding within an Australian inpatient mental health service.

Objective: Patients admitted to mental health services may exhibit behaviours of concern (BOCs) such as aggression, self-harm, absconding and sexual harm. BOCs can lead to restrictive interventions, which have adverse effects on patients, carers and staff. This paper aims to explore the nature and outcome of BOCs within an adult inpatient mental health setting.

Reflection of a 2-year journey since the introduction of psychiatric behaviour of concern (Psy-BOC) call, a medical emergency team (MET) call equivalent for the deteriorating mental health of patients.

Objective: To reflect on the challenges encountered and the resultant cultural changes that occurred during the implementation of psychiatric behaviour of concern (Psy-BOC), a medical emergency team (MET) equivalent for the deteriorating mental health of patients within an adult psychiatric inpatient unit.

Conclusions: Implementing Psy-BOC on an adult psychiatric inpatient unit has been challenging, but it has successfully embedded a systematic approach to early escalation and capacity building to prevent and manage harmful behaviours.

Measuring the impacts of seclusion on psychiatry inpatients and the effectiveness of a pilot single-session post-seclusion counselling intervention.

Despite the accumulation of evidence demonstrating patients' accounts of trauma associated with seclusion, the use of evidence-based post-seclusion debriefing is not apparent in the published work. This study aimed to identify the impacts seclusion has on an individual using the Impact of Events - Revised (IES-R), a standardized and widely used measure of trauma symptoms, and measure the effectiveness of a post-seclusion counselling intervention in mitigating the experience of seclusion-related trauma and reducing time spent in seclusion. The study design involved a comparison of the seclusion-related trauma and time in seclusion that was experienced by consenting patients managed on the two inpatient wards of Alfred Psychiatry.