Self-Determination Theory: A Framework Well Suited to Informing Research of Adverse Inpatient Mental Health Experiences

• Published in: Issues in mental health nursing 2024-10, Vol.45 (10), p.1046-1053
• Main Authors: Raeburn, Toby, Chang, Claire R, Kuek, Jonathan Han Loong, Ndwiga, Dorothy W
• Format: Article
• Language: English
• Subjects: Adverse; Boredom; Coercion; Frame analysis; Health care; Health care expenditures; Health services; Humans; Inpatient care; Inpatients - psychology; Loneliness; Mental Disorders - psychology; Mental Disorders - therapy; Mental health; Mental health services; Patient Isolation - psychology; Personal Autonomy; Psychiatric Nursing; Psychological needs; Psychological Theory; Psychological well being; R&D; Recovery; Research & development; Self determination; Social isolation; Therapeutic alliances; Translation; Well being
• ISSN: 0161-2840; 1096-4673; 1096-4673
• DOI: 10.1080/01612840.2024.2385566

Contrary to the expectations and intentions of inpatient mental healthcare, reports of adverse experiences by people admitted to inpatient settings are common and on the rise. Such experiences negatively impact individuals' mental health and recovery and incur costs to their networks, mental health providers, the healthcare system, and society at large. Research indicates ongoing challenges in understanding and addressing the complex interplay of factors that contribute to a diverse range of adverse experiences, from seclusion, restraint, and coercion, to boredom, loneliness, and lack of therapeutic relationships. There is a pressing need to better understand the mechanisms of adverse inpatient mental health experiences and identify frameworks to aid in more efficient and effective translation of knowledge into practice. This paper proposes self-determination theory (SDT) as a framework that can assist nurse researchers and practitioners elucidate the nature of adverse experiences and guide developments to mitigate adverse outcomes. Critically, SDT prioritises human psychological needs and wellbeing, and thus has potential to inform rights-based, person-centred, recovery-oriented research and development. This paper provides an overview of recent literature on adverse experiences before introducing SDT. It then considers adverse inpatient mental health experiences through the lens of SDT, providing actionable guidance for nursing research and development.