Geoffrey L Dickens

Northumbria University · Nursing Midwifery and Health

Mental health nurses have traditionally lagged in terms of physical healthcare skills and have been found to have poorer cultural safety-related attitudes relative to other nurses. Organisational culture, including safety-related culture, is associated with important aspects of care quality. The aim of the current study was to examine the relations...

Background: Structured risk assessment schemes can aid violence reduction in mental health and correctional settings. However, the properties and effectiveness of schemes for predicting imminent (within 24-h) violence have not been comprehensively reviewed. Objectives: To systematically review the properties and predictive performance of structu...

Introduction Attitudes are considered integral to mental health nursing practice. Aims To comprehensively describe the i) measured attitudes of UK mental health nurses towards people and practice; ii) effectiveness of interventions to change attitudes; and iii) relationships between their attitudes, other variables/constructs, and practice. Metho...

Self-harm is common in mental health facilities and coercive containment measures are sometimes used to manage it. Nurses’ attitudes towards these measures have been investigated in relation to disturbed behaviour in general, but rarely to self-harm specifically. We therefore investigated mental health nurses’ use of and attitudes towards coercive...

Introduction Considerable guidance is available about the implementation of leave for detained patients, but individual mental health services are free to determine their own policies. Aim To determine how consistent leave policies of NHS mental health services in England and Wales are with relevant guidance and legislation. Method A national aud...

Introduction Quantification of the social climate of mental health care environments has received considerable attention. Investigations of the resulting measures indicate that social climate is associated with individual outcomes including patient satisfaction and staff burnout. Interest has grown in developing interventions to improve social clim...

Introduction Violence risk assessment is commonplace in mental health settings and is gradually being used in emergency care. The aim of this review was to explore the efficacy of undertaking violence risk assessment in reducing patient violence and to identify which tool(s), if any, are best placed to do so. Methods CINAHL, Embase, Medline, and W...

Aims Psychological First Aid is a brief intervention based on international guidance from the World Health Organisation. Free to access online training in the intervention was introduced during the COVID-19 pandemic in UK. We aimed to determine the uptake of Psychological First Aid training among healthcare workers in care homes in the UK and to as...

Aims Psychological First Aid is a brief intervention based on international guidance from the World Health Organisation. Free to access online training in the intervention was introduced during the COVID-19 pandemic in UK. We aimed to determine the uptake of Psychological First Aid training among healthcare workers in care homes in the UK and to as...

Introduction: Nurses are the largest professional disciplinary group working in mental health services and have been involved in numerous trials of nursing-specific and multidisciplinary interventions. Systematic appraisal of relevant research findings is rare. Aim: To review trials from the core Anglosphere (UK, US, Canada, Ireland, Australia,...

Background The pandemic and its related social restrictions have led to many uncertainties in nursing education, including the fear of infection in clinical learning settings and the challenge of remote learning. The modification of clinical and academic environments generated anxiety and academic concerns among nursing students. Objectives To exp...

Introduction The Insomnia Severity Index (ISI) is a self-administrated questionnaire most frequently used to assess insomnia in clinical and non-clinical populations. Objective To evaluate the psychometric properties of the Arabic ISI among patients diagnosed with chronic diseases. Methods A cross-sectional and descriptive correlational design wa...

Background The Covid-19 pandemic has produced unprecedented challenges across all aspects of health and social care sectors globally. Nurses and healthcare workers in care homes have been particularly impacted due to rapid and dramatic changes to their job roles, workloads, and working environments, and residents’ multimorbidity. Developed by the W...

Exploring the experiences of adolescent caregivers of mentally ill parents is essential to understand their challenges and identify their care needs. Using a qualitative research design, 18 caregiving adolescents shared their experiences of living with and providing care to a parent with a severe mental illness. The analysis of the interviews resul...

Background The new coronavirus disease (COVID-19) carries a high risk of infection and has spread rapidly around the world. However, there are limited data about the clinical symptoms globally. The purpose of this systematic review and meta-analysis is to identify the prevalence of the clinical symptoms of patient with COVID-19. Methods A systemat...

Aim There is a lack of clarity about the components which would signify appropriate psychological strengths among nursing student candidates. This study was conducted to identify such components from the viewpoint of the clinical nurses and nursing instructors. Design A qualitative study. Methods This study comprised qualitative research using a...

Aim and objectives: To evaluate and examine the utility of the Violence Prevention Climate scale by generalist healthcare professionals. Background: Workplace violence in general hospital settings remains a challenge for healthcare organisations. High rates of violence are still being reported towards healthcare workers, despite organisational v...

We read MacLachlan et al.’s (2021) open letter with considerable interest. The authors scrutinize and set out their case against the replacement of the term ‘mental disorder’ with 'mental illness’ in the new Irish Mental Health Act. We are three UK-based mental health nurse academics, all recently employed at Northumbria University, and have accept...

Purpose: Ward climate can shape the behaviour of both staff and patients. A subset of the ward climate is the violence prevention climate, the unique characteristics that are perceived by the people within the environment as contributing towards the prevention of violence. The aim of this study was to explore differences between and within staff a...

Aim: To evaluate whether a two-part culture improvement program aimed at nurses in clinical and managerial positions in an inpatient mental health service was associated with culture-change, and safety-related behaviour and knowledge improvements. Background: Due to serious failings in the delivery of physiological care to mentally disordered inpa...

Since its development there has been growing utilisation of the Safewards package of interventions to reduce conflict and containment in acute mental health wards. The current study used the opportunity of an implementation of Safewards across one large metropolitan local health district in New South Wales Australia to evaluate change. Specific aim...

Ward social climate is an important contributor to patient outcomes in inpatient mental health services. Best understood as the general ‘vibe’ or ‘atmosphere’ on the unit, social climate has been subject to a significant research aimed at its quantification. One aspect of social climate, the violence prevention climate, describes the extent to whic...

Poor hand hygiene is a major contributor to hospital acquired infection. In this study, a comparison of the related attitudes of psychiatric and non-psychiatric nurses was made using a cross-sectional survey design. N¼79 nurses who work in psychiatric or non-psychiatric hospital wards completed questionnaires regarding intended compliance with hand...

Inpatient aggression on mental health wards is common and staff-patient interactions are frequently reported antecedents to aggression. However, relatively little is known about the precise relationship between aggression and these interactions, or their relationships with aggression and staff containment responses such as restraint and seclusion....

Aims and objective: The objective of the current study was to capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer. Background: Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused...

Background: Mental health professionals’ attitudes to people with Borderline Personality Disorder can be negative. No systematic review to date has examined how service-users and their families experience professional care. Aims: To critically synthesise evidence of service-users’ and families’ subjective experience of mental health care for borde...

Full text available for 50 days (21 May on) https://authors.elsevier.com/a/1Z50B4jxxzkFz Background From a baseline of near zero, there has in recent years been a growing number of empirical studies related to mental health nurses’ delivery of healthcare for severely physically deteriorating patients or in medical emergency situations. To date, t...

Background There has been a recent growth in research addressing mental health nurses’ routine physical healthcare knowledge and attitudes. We aimed to systematically review the empirical evidence about i) mental health nurses’ knowledge, attitudes, and experiences of physical healthcare for mental health patients, and ii) the effectiveness of any...

Mental health inpatients’ self-reported violence risk predicts actual aggressive outcomes. Anger, for which there are well-evidenced interventions, commonly precedes inpatient aggression. We aimed to determine whether patients’ self-reported anger added incremental validity to violence prediction beyond routinely completed violence risk assessments...

Aims and objectives To evaluate and explore mental health nurses’ responses to and experience of an educational intervention to improve attitudes towards people with a diagnosis of Borderline Personality Disorder. Report findings are concordant with relevant EQUATOR guidelines (STROBE and COREQ). Background Attitudes towards people with a diagnosi...

Objectives: This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants. Methods: This was a descriptive correlational study. Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital...

Self‐harm is common on mental health wards; an unsurprising fact given that the patient group comprises some of the most unwell people from the local community. One systematic review of 25 studies (Swannell et al 2014) suggested a pooled prevalence for self‐harm by inpatient mental health service users of 17.4% (range 0.7% – 68.8%) including up to...

This chapter describes a literature review undertaken to establish current evidence around the practice of giving 'leave' to patients in secure/ forensic mental health services, particularly the mental health nursing role.

Missing persons incidents incur considerable societal costs but research has overwhelmingly concentrated on missing children. Understanding of the phenomenon among adults is underdeveloped as a result. We conducted an evolutionary concept analysis of the ‘missing person’ in relation to adults. Evolutionary Concept Analysis provides a structured nar...

https://rdcu.be/bamYC Introduction: Harm-reduction approaches for self-harm in mental health settings have been under-researched. Aim: To develop a measure of the acceptability of management approaches for self-cutting in mental health inpatient settings. Methods: Stage one: scale items were generated from relevant literature and staff/service us...

FREE FULL TEXT FOR 50 DAYS https://authors.elsevier.com/c/1Xjsb4jxxvwMO Background Violence and aggression are common in inpatient mental health hospital settings and cause problems for staff, patients and organisations. An important factor in treatment efficacy is ward atmosphere, and one element of this is the violence prevention climate. Obje...

Problem: Community-based mealtime management is an intensive, focused, and time-limited intervention for young people with an eating disorder which aims to support re-feeding at home and thus prevent hospital admission. Little is known about clinicians’ experiences of delivering this intervention. We aimed to explore mental health clinicians’ persp...

BACKGROUND: There is increasing interest in the use of commercial movies in nursing education, or 'cinenurducation'. There is a need for educational interventions which target mental health nurses' attitudes towards people with borderline personality disorder. OBJECTIVES: To investigate and evaluate the experience and effects of attendance at a scr...

The consideration of protective factors has been integrated into a number of instruments whose aim is assess the risk of adverse outcomes among adolescents in high-risk mental health and criminal justice populations; however, little is known about their contribution to accurate risk prediction. We systematically reviewed the evidence for predictive...

Aim: To identify, critically evaluate, and synthesise the empirical evidence about therapeutic leave from mental health inpatient settings. Background: “Leave” occurs when a mental health inpatient exits the hospital ward with the appropriate authorisation alone, or accompanied by staff, family, or friends. Limited research has previously addressed...

Introduction Emotional regulation is important in mental health nursing practice but individual emotions may require different regulation strategies. There is ample evidence that nurses experience anger specifically during their work, for example when experiencing patient aggression. It is, therefore, important to consolidate what is known about ho...

Objective: The individual recovery outcomes counter is a 12-item personal recovery self-assessment tool for adults with mental health problems. Although widely used across Scotland, limited research into its psychometric properties has been conducted. We tested its’ measurement properties to ascertain the suitability of the tool for continued use i...

Background De-escalation is the recommended first-line response to potential violence and aggression in healthcare settings. Related scholarly activity has increased exponentially since the 1980s, but there is scant research about its efficacy and no guidance on what constitutes the gold standard for practice. Objectives To clarify the concept of...

The Short-Term Assessment of Risk and Treatability (START) assists risk assessment for seven risk outcomes based on scoring of risk and protective factors and assignment of clinically-informed risk levels. Its predictive validity for violence and self-harm has been established in males with schizophrenia, but accuracy across pathologically diverse...

Background: Mental health nurses are exposed to patient aggression, and required to manage and de-escalate aggressive incidents; coercive measures such as restraint and seclusion should only be used as a last resort. An improved understanding of links between nurses' exposure to aggression, attitudes to, and actual involvement in, coercive measure...

Background: Structured risk assessment to aid prediction and prevention of risk behaviours in secure settings is common; the expected benefits have rarely been investigated. Aims: To determine whether adverse outcomes (physical and verbal aggression, self-harm, victimisation, self-neglect, unauthorised leave, substance abuse) reduced after patients...

Purpose The purpose of this paper is to explore how raters combine constituent components of Historical Clinical Risk-20 (HCR-20) risk assessment, and how relevant they rate the tool to different diagnostic and demographic groups. Design/methodology/approach A cross-sectional survey design of n =45 mental health clinicians (psychiatrists, psycholo...

Secure mental health service outcomes are commonly derived from post-discharge recidivism, readmission and mortality rates. Information about less rare behavioural, functional, and symptom-related outcomes across the sometimes lengthy span of admission is scant. We aimed to determine whether patients underwent reliable and clinically significant ch...

Background Clozapine is an atypical antipsychotic medicine which can cause significant side-effects. It is often prescribed off-license in severe cases of borderline personality disorder contrary to national treatment guidelines. Little is known about the experiences of those who take clozapine for borderline personality disorder. We explored the l...

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care pla...

Protective factors are neglected in risk assessment in adult psychiatric and criminal justice populations. This review investigated the predictive efficacy of selected tools that assess protective factors. Five databases were searched using comprehensive terms for records up to June 2014, resulting in 17 studies (n = 2,198). Results were combined i...

The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its'component parts contribute to the assignment of risk estimates and...

Objectives There is some evidence that mental health nurses have poor attitudes towards people with a diagnosis of borderline personality disorder and that this might impact negatively on the development of helpful therapeutic relationships. We aimed to collate the current evidence about interventions that have been devised to improve the responses...

Aims and objectivesTo establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways whi...

The Psychology of Arson is the first book in its field to focus specifically on contemporary topics relevant to practitioners and professionals working with adolescent and adult deliberate firesetters. Rebekah Doley, Geoffrey Dickens and Theresa Gannon have integrated the very latest information regarding prevalence, theory, research and practice i...

In this final chapter we identify future research priorities for the advancement of firesetting-related knowledge . We do not intend to provide an exhaustive account of every possible future research avenue but we do aim to be sufficiently ambitious that our suggestions will not be exhausted in the near future. The results of any future research wi...

KEY POINTS • One in ten patients in secure mental health settings have a conviction for deliberate firesetting. This chapter views the issue of inpatient care and management from a forensic mental health nursing perspective. • Hodges’ Health Career – Care Domains – Model (HCM; Hodges, 1998) is used to provide an overview of the political, biologic...

It is in all likelihood a by-product of human evolution, and of the complexity of the human brain and of society, that there have always been dysfunctional individuals who present overtly with a mental or behavioural disorder. They may cause significant harm and disruption to others, as well as to themselves. The most seriously affected depend on t...

Objective: Periodic structured violence risk assessment is the principle method underlying treatment planning for mentally disordered offenders but little is known about how risk changes over time. We aimed to determine whether hospitalised patients underwent reliable clinical change in assessed risk. Method: We used a pseudo-prospective longitu...

In any society a small proportion of people with mental disorder present with behaviour that transgresses norms and violates the rights of others. Yet these people are often vulnerable themselves to violence, abuse or exploitation by others, or may be at risk of neglect or self-harm. Long conceptualised as a ‘forensic’ population, there has been a...

Accessible summary: The Short-Term Assessment of Risk and Treatability (START) is a tool used in some mental health services to assess patients to see if they are at risk of violence, self-harm, self-neglect or victimization. The recommended time between assessments is 3 months but there is currently no evidence to show that this is best practice....

Violent and non-violent sexual behaviour is a fairly common problem among secure mental health service patients, but specialist sexual violence risk assessment is time-consuming and so performed infrequently. We aimed to establish whether a commonly used violence risk assessment tool, the Health Clinical Risk management 20(HCR-20), has predictive v...

Despite evidence about the negative effects of verbal aggression in mental health wards there is little research about its prevalence or about the factors that predict the behaviour among inpatients. This study aimed to determine the prevalence of verbal aggression in a secure mental health service, and to examine the relationship of verbal aggress...

The START predicts aggressive outcomes and to some extent self-harm. However, it is not known whether gender moderates its performance. This study used routinely collected data to investigate the predictive ability of the START for aggression and self-harm in secure psychiatric patients. Utility of the START was examined separately for men and wome...

Few studies have adequately explored the characteristics of male and female mentally disordered firesetters and compared these to those of non-firesetting mentally disordered offenders. Further, there is a paucity of research examining the characteristics which can predict repeat firesetting within this population. The current study aimed to examin...

De-escalation is an important tool for preventing aggression in inpatient settings but definitions vary and there is no clear practice guideline. We aimed to identify how clinical staff define and conceptualize de-escalation, which de-escalation interventions they would use in aggressive scenarios, and their beliefs about the efficacy of de-escalat...