Containment and therapeutic relationships in acute psychiatric care spaces: the symbolic dimensions of doors

Background There is an increasing trend of door locking practices in acute psychiatric care. The aim of the present study was to illuminate the symbolic dimensions of doors in Greek mental health nurses’ experiences of open and locked working spaces. Results A sequential mixed-method designexplored the experiences of nurses working in both open and locked psychiatric acute care units. Participants experiences revealed four types of doors related to the quality of recovery-oriented care: (a) the open door, (b) the invisible door, (c) the restraining door, and (d) the revolving door. Open doors and permeable spacesgenerated trust and facilitated the diffusion of tension and the necessary perception of feeling safe in order to be involved in therapeutic engagement. When the locked unit was experienced as a caring environment, the locked doors appeared to be “invisible”. The restraining doors symbolized loss of control, social distance and stigma echoing the consequences of restrictingpeople’s crucial control over spaceduring the COVID-19 pandemicin relation toviolence within families, groups and communities. The revolving door (service users’ abscondence/re-admission) symbolised the rejection of the offered therapeutic environment and was a source of indignation and compassion fatigue in both open and locked spaces attributed to internal structural acute care characteristics (limited staffing levels, support, resources and activities for service users) as well as ‘locked doors’ in the community (limited or no care continuity and stigma). Conclusions The impact of COVID-19 restrictions on people’s crucial control of space provides an impetus for erecting barriers masked by the veil of habit and reconsidering the impact of the simple act of leaving the door open/locked to allow both psychiatric acute care unit staff and service users to reach their potential.

Detained during a Pandemic: Human Rights behind Locked Doors

Every year, thousands of people are detained in United States immigration detention centers. Built to prison specifications and often run by private companies, these detention centers have long been criticized by academics and advocacy groups. Problems such as overcrowding and lack of access to basic healthcare and legal representation have plagued individuals in detention centers for years. These failings have been illuminated by the COVID-19 pandemic, which has disproportionately impacted detained migrants. Against a human rights backdrop, this article will examine how the U.S. immigration detention system has proven even more problematic in the context of the pandemic and offer insights to help avoid similar outcomes in the future.

Dying in the Margins: A Literature Review on End of Life in English Prisons

This paper explores dying in English prisons. Whilst often conflated, death and dying are conceptually different. While there is increased attention given to the investigation of deaths in custody, and the impact of prison deaths on healthcare staff and custodial staff, little attention has been paid to the experience of dying people themselves. Post-death investigations tell us little about dying experiences of the dying. This paper reviewed the literature on dying in English prisons and highlights this clear gap in knowledge. Four types of dying will be discussed in this paper: (1) suicide, (2) dying in older age, (3) deaths post-release, and (4) COVID-19 deaths. The importance of providing good end-of-life care and palliative care in prison is acknowledged in the literature, but this only shows awareness of the needs of a particular part of the prison population. To understand the complexities and nuances of dying in prison, all voices need to be included in research, otherwise what is left post-death of a person who died in prison is a Fatal Incidence Report. More empirical research is needed to illuminate the diversity of prison deaths and the lived reality of those dying behind locked doors.

How Covid Flipped the Classroom: Learning from the Next Generation of Gerontologists

Covid laid bare the structural inequities and systemic challenges facing LTC, both in terms of risk and neglect. Lost in the daily tally of new cases and mortality rates are the stories of essential workers who have neither degree nor stature in the field, yet who fulfill an awesome responsibility—caring for older adults no longer visible behind locked doors. Suddenly, these full-time students and part-time workers found themselves employed in one of the most dangerous occupations in the country—providing direct care in nursing homes and assisted living communities. This award lecture highlights their voices and lessons learned.

Locked Doors

This chapter addresses a key theme in the debates on post-Ottoman societies: what does it mean to live together? And what does it mean to share a social space with others? What do these question mean in the face and memories of radical social and political ruptures? These questions are ethnographically explored through the idea of neighborliness (komšiluk), and ethics of proximity. Through detailed life histories and ethnographic case studies, ranging from the arranging of funerals and neighborhood hospitality to lending a hand, this chapter documents how the changing character of interpersonal relations in village neighborhoods commonly expressed through neighborhood-related idioms mirrors larger socioeconomic reconfigurations of Bosnia-Herzegovina, and in particular rising economic inequalities between the villagers that are felt and debated as newly emerged hierarchies between the “winners” and the “losers” of the postwar years.