Description

The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute. Children considered restraints and seclusion could help them feel safe in certain instances, for example if another child was being aggressive towards them or in exceptional cases to prevent self-injury. However, their own experiences of being restrained were predominantly negative, especially if not knowing the reason for their use, which they then found unfair. Some of the children emphasized the punitive nature of the use of restraints and seclusion, and most children disagreed with these practices when used as a punishment.

Children's perspectives also highlighted the limits of the use of a uniform de-escalation approach by the staff to manage crises. Children considered discussing with the staff and developing a relationship with them as more helpful in case of a crisis then the use of a de-escalation approach or coercive strategies.There are at least five different areas of difficulties in the communication process, namely, intra- and inter-organizational behaviours between organizations, from organizations to the public, from the public to organizations, and within systems of organizations. Exercise of authority difficulties stem from losses of higher echelon personnel because of over-work, conflict regarding authority over new disaster tasks, and clashes over organizational jurisdictional differences. Co-ordination difficulties come from lack of consensus among organizations, working on common but new disaster-related tasks, and difficulties in achieving overall co-ordination in any community disaster that is of any magnitude. Prior planning can limit these management difficulties but cannot completely eliminate all of them.

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With Regards
Cristy
Journal Coordinator
Journal of Annals of Behavioural Science