‘It comes with the territory’ – Staff experience with violation and humiliation in mental health care – A mixed method study [2020]

Highlights
• A high amount of MHC staff report experiences of being violated and humiliated during work.

• The participants’ perceptions of the users and their behaviour seem to influence their experience.

• Male workers were more often victims of serious physical violence, and women were more often targets for sexual harassment.

• Participants considered being exposed to violence and humiliation to be part of the job when working in mental health care.

Abstract
Background
The aim of this study was to investigate staff’s experiences with violation and humiliation during work in mental health care (MHC). A total of 1160 multi-professional MHC staff in Norway responded to an online questionnaire about their experiences with different kinds of violation and humiliation in the MHC setting. In addition, a sample of professionals (eight MHC nurses) were recruited for in-depth individual interviews.

Method
The study used an explorative mixed method with a convergent parallel design; this included a web-based questionnaire to MHC staff in combination with individual interviews. The sample is considered to be equivalent to staff groups in MHC in Norway.

Results
Between 70 and 80% of the staff reported experiencing rejection, being treated with disrespect, condescending behaviour or verbal harassment. Male workers were significantly more often victims of serious physical violence, and women were significantly more often targets for sexual harassment. In interviews, participants said they considered being exposed to violence and humiliation to be part of the job when working in MHC, and that experience, as well as social support from colleagues, helped MHC practitioners to cope better with violent situations and feel less humiliated at work.

Discussion
A high amount of MHC staff report experiences of being violated and humiliated during work. The participants’ perceptions of the users and their behaviour seem to influence their experience of feeling violated and humiliated. Knowledge about the dynamics of aggression between staff and users in MHC may be used in safeguarding staff and users, prevent coercion and heighten the quality of care.

Tonje Lossius Husum, Vera Thorvarsdottir, Olaf Aasland, Reidar Pedersen
International Journal of Law and Psychiatry, Volume 71, July–August 2020
DOI
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