Accessible Summary
What is known on the subject
The first access to a mental health service is sometimes marked by aggressive behaviours and anger. Forced hospitalization is frequently an occasion for resistance and hostility to the service, which should not be mistaken for psychotic symptoms.
If this situation is not dealt with effectively, it can jeopardize the quality of the relationship with staff and compliance with the treatment programme.
What the paper adds to existing knowledge
The narrator presents his experience in undergoing voluntary psychiatric treatment, casting light on nurses’ good and bad practices: those that increased resistance, and those that helped de‐escalate the uncontrolled reaction at the time of access, as well as during the recovery period.
What are the implications for mental health nursing
Practitioners should be able to put in place listening techniques and ways of personalizing the relationship with the patient.
When such measures become part of the patient’s meaning system, the vicious circle of misunderstood anger that creates more anger may be interrupted and the patient can invest in relationships of trust.
Abstract
Aggression is often a reason for psychiatric hospitalization and may lead to prolonged hospital stays, and at worst to compulsory treatments. The relationship between mental illness and aggressive behaviour is a source for debate in the literature, while research data suggest that violent behaviour is impacted not only by the mental state of the patient, but also by environmental and relational conditions, hence the importance of an increased awareness of operating methods on the part of psychiatric staff. Alex’s story is an effective mirror for rethinking staff conduct and offers many practical suggestions for understanding a patient’s point of view in critical episodes and for deescalating relational tension.