CoChat
Sign Up
Cited by 24Healthcare Decision-Making and RestraintsPsychiatric care and mental health servicesHistorical Psychiatry and Medical Practices

“My life isn’t my life, it’s the systems”: A qualitative exploration of women’s experiences of day-to-day restrictive practices as inpatients

Open access
Tully, Sarah Michelle, Bucci, Sandra, Berry, Katherine·2023·Journal of Psychiatric and Mental Health Nursing
DOI 10.1111/jpm.12855PMC PMC10084424
Open this paper in CoChat — free accountOpen PDF

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Sometimes someone needs to be in hospital because they are struggling with their mental health and need some extra support but being in hospital can also be a difficult experience. There are a lot of restrictions in place in hospital, like locked doors, rules to follow and not much choice about what happens to you. Other research has found that these restrictions can feel difficult and stressful for people and so more research is needed about this. We wanted to know what being in hospital felt like for women in particular. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We interviewed women who were in hospital because of their mental health about what it was like for them in hospital. The women told us that they felt powerless while they were in hospital. They sometimes felt like they were being punished and this could affect their mood and could lead to them hurting themselves. They also said that they were not always listened to by staff, and they found it difficult being away from their family and friends while they were in hospital. The women also told us that being in hospital could sometimes help them to feel safe. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Women should be looked after in hospital in a way that helps them to feel in control of what happens to them. They should be supported to be able to go outside the hospital on leave, to keep in touch with their family and friends, and they should be listened to by staff. A project called "safewards" has suggested some ways for helping to make hospital wards safer. They have suggested that everyone should be clear about what the rules are when they go into hospital and ways that staff could communicate more clearly with the people they are working with. Our research supports using these techniques. ABSTRACT: Introduction Inpatient care often involves restrictive interventions such as seclusion and restraint and restrictive practices that limit the person's freedom, rights and daily activities. Restrictive practice has not been the explicit focus in previous research; however, it often appears as an important theme, with participants identifying it can have a detrimental effect on their well-being. More research specifically on this topic in an inpatient setting is, therefore, needed. Women might be particularly vulnerable to adverse effects of restrictive practices compared to men as women generally occupy less powerful positions in society and more often experience abuse. Aims The study aimed to explore women's experiences of routine restrictive practices in mental health inpatient settings. Methods Twenty-two women who were currently inpatients on mental health wards were interviewed about their experiences of restrictive practices in hospital. Interviews were analysed using thematic analysis. Results An overarching theme emerged of powerlessness. Four key sub-themes were also identified: restrictions perceived as punitive, having no voice, impact of restrictions on relationships and restrictions providing safety and support. Discussion Although restrictive practices were found to provide the women with a sense of safety, they were also found to impact upon the women's well-being, leading to increases in self-harm and over-reliance on restrictions. Implications for practice This research highlights the importance of gender-informed inpatient services for women that foster independence, empowerment and allow women to have their voices heard. Safewards interventions such as clear mutual expectations and soft words could contribute to mitigating the impact of restrictive practices.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/jpm.12855

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Rigid rules and routines were the most consistently reported as restrictive in the literature.

    “it was the rigid rules and routines that were most consistently reported as restrictive in the literature [51,89,102,104,114,141,142,145,149,152,153,161].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [141]

    The Introduction identifies blanket rules and compulsory ward routines as restrictive practices, so the paper supports the link between rules, routines and restriction. It does not establish that rigid rules and routines were the most consistently reported restrictions across the literature; its Results also describe some structured routines as beneficial. Page numbers are unavailable in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • These studies shed light on how structural factors such as rigid ward rules, locked units, lack of privacy, resource scarcity, and dehumanizing practices deeply influence individuals' perceptions of coercion.

    “For instance, these studies shed light on how structural factors such as rigid ward rules, locked units, lack of privacy, resource scarcity, and dehumanizing practices deeply influence individuals’ perceptions of coercion [51,89,102,104,114,141,142,145,149,152,153,161].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [141]

    The Introduction describes locked doors and blanket ward rules, and the Results (‘Restrictions perceived as punitive’ and ‘Overarching theme: Powerlessness’; page not provided) show how restrictions made women feel controlled, punished, and unheard. These passages support the claim’s central point about ward practices shaping experiences of coercion, but our copy does not establish lack of privacy or resource scarcity as factors. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Not being heard by healthcare professionals increased feelings of loss of control among women hospitalized in psychiatry.

    “For example, not being heard by healthcare professionals increased feelings of loss of control among women hospitalized in psychiatry [141].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [141]

  • Patients described restrictions such as prohibitions on smoking, coffee, or going outside, the inability to use a phone, and needing staff permission for basic needs as profound losses of control.

    “Patients described restrictions such as prohibitions on smoking, coffee, or going outside [102,142], the inability to use a phone [152], and needing staff permission for basic needs [114,141] as profound losses of control.”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [141]

  • The experience was particularly distressing when patients were not informed of the rules yet penalized for breaking them or when staff enforced policies rigidly rather than flexibly.

    “The experience was particularly distressing when patients were not informed of the rules yet penalized for breaking them [89,141] or when staff enforced policies rigidly rather than flexibly [104,153,161].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [141]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

1 of the 37 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. NICE. (2015). Violence and aggression: short‐term management in mental health, health and community settings. https://www.nice.org.uk/guidance/ng10 26180871
  2. Pashley, S., Denison, S., & Moore, H. (2018). Exploring the lived experience of women in secure care services. National Conference: Women in Secure Care.
  3. Wienclaw, R. A. (2011). Sociology reference guide: Gender Roles & Equality. The Editors of Salem Press.

Cited by

Sorted by citations

Related

Authors
Tully, S. M., Bucci, S., & Berry, K.
Affiliations
Greater Manchester Mental Health NHS Foundation Trust (GB)
Corresponding author
Tully, Sarah Michelle
ORCID
Venue
Journal of Psychiatric and Mental Health Nursing
Publisher
Wiley
Published
2022-07-18
Volume
30
Issue
1
Pages
110-122
ISSN
  • 1351-0126 (ISSN-L)
  • 1365-2850
DOI
10.1111/jpm.12855
PMC
PMC10084424
OpenAlex
W4283734156
Cited by
24
References
37
Citations by year
2026: 4 · 2025: 15 · 2024: 2 · 2023: 2 · 2022: 1
FWCI
4.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Psychiatric and Mental Health Nursing (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
Keywords
restrictive practices, seclusion, physical restraint, women's mental health, inpatient care, women's experiences, powerlessness, internal communication, family contact, self-harm, patient safety, psychiatric ward, gender vulnerability, patient well-being
MeSH terms
Emotions, Female, Humans, Inpatients, Male, Mental Health, Restraint, Physical, Qualitative Research

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review