Challenging behaviour in Mental Health Services: Combining psychological perspectives

Abstract

Background: The shift of emphasis from hospital to community care in mental health services means that patients in hospital present some of the most complex and challenging problems. High levels of staff stress are likely consequences, and so staff working under these circumstances need both appropriate skills and emotional support.

Aims: To review evidence on the causes and management of challenging behaviour in mental health services and its impact on direct care staff, and report on an innovative approach that integrates different bodies of knowledge and psychological theories to provide a coherent approach to training and supporting the staff group.

Method: Literature review and description of behaviour analysis and training and support (BAITS) and its relation to this evidence.

Results: There is sufficient evidence to recommend psychological approaches that address the problem of challenging behaviour in mental health services. These are based on functional analysis and address staff motivation as a central concern. BAITS is one such approach.

Conclusions: BAITS integrates diverse psychological approaches and provides services that have been highly valued by the direct care staff receiving them. There is preliminary evidence of benefits to service users and staff. There is a need for further effectiveness research.

Keywords:

• Challenging behaviour
• mental health
• psychological