Secure Unit Conflict & Containment

This is where my concerns with this lie - I work in a medium secure environment with alot of our patients being very creative in their self harming behaviours. Im loving the safe wards model and ideas - we're just going to have to get creative to implement it. Alot of the calm down box items are contraband or restricted in the environment in which I work so going to be a lot of thought needed but its exciting stuff

Hi, I'm a student MH nurse and I've recently had a placement within a hospital where safewards had been implemented on a medium secure unit.. The Calm Down Box on this unit was kept in the ward office away from patients, there was a sign in/out book for if a patient used the box, the items were signed in and out as a security measure. If you're still struggling with restricted items, this could be an idea for your ward.
I think also, patients were supervised while they had their item, but I'm not certain about this.

Hi All

I am in the process of implementing Safewards : for a low secure forensic unit in South Wales. We are starting off with:
Soft words
Getting to Know you
Discharge messages

Any ideas/thoughts on safely displaying the information on the unit walls so its visible for patients? I am using stencils where I can... safe/secure display units are very expensive to purchase!

Also - any ideas for the calm down box ? In terms of patients at very high risk of self harm - what are others using in the box? Signing in and out is a good idea and we will be doing this....

Also, are others displaying the getting to know you information on the wall or in a folder? Ideally I think on the wall would be more beneficial to patients...folders tend to end up sat on shelves!?

Many thanks, Becky

Hi all
I work on a low secure LD forensic unit. We are also struggling with the calm down box. We have found most of the suggested items to be inappropriate for our patient group. At the minute our plan is to have a small box with some stress balls and some mindfulness colouring books and some pens and pencils. We will also be putting some posters around the ward with breathing and relaxation techniques. We are also currently running yoga classes, and have plans to display 'how to...' with yoga poses. We have also created some posters that describe things people can do to help them relax such as have a bath, listen to music, have a dance etc. I would be interested to know what other forensic units are putting in their boxes.

We are also struggling with the discharge messages, as some of our patients have been here for a considerable length of time. We are planning to do a 'path to discharge', where staff and patients will put stepping stones for different criteria, such as 'If i go to all of my psychology sessions, my treatment will take less time', 'OT sessions will give me life skills to help me when I am discharged' etc. We may start collecting discharge notes off of people when they leave, but it would seem a bit sad to just have one or two up.

Again any ideas or suggestions would be welcomed.

Hi Bridget,

Welcome to the forum.

Some places have worked with LD patients by helping them each create their own box of self-soothing activities. And this contains the larger answer really - consult the patients on what things they find help them relax and distract them, and make those available one way or another.

As for discharge messages, this is a common issue for longer term units. In these places messages can be taken at transfers, or shared across a whole unit to produce a critical mass. Alternatively periodically festivals like Christmas can be used to collect a new crop of messages for display. Or you could use your stepping stones idea in this way (I like that). What is important is that the messages are honest and from the patient concerned to the other patients on the unit.

Good luck,

Len