Creating change: implementation of an inpatient behavioural activation programme on a psychiatric intensive care unit

Background: Patient boredom has been identified as an important issue within psychiatric inpatient units. A lack of therapeutic activities may result in patient boredom, with consequences of ensuing patient aggression and threatened staff safety.

Aim: Our team identified the presence of boredom within our psychiatric inpatient unit. We decided to implement a modified behavioural activation intervention to address this issue with the broader goal of impacting the milieu of this patient environment.

Method: Self-report measures regarding approach and avoidance behaviours as well as free time boredom were collected from patients and in-depth semi-structured interviews were conducted with both patients and staff members. Analysis of interviews used a constant comparative analysis. A thematic approach was taken; data was collected until thematic saturation was reached.

Results: Quantitative results revealed some modification in the amount of free time boredom expressed by our patients. Qualitative analysis of the patient interviews revealed two main categories: (1) activities can be beneficial; and (2) patient engagement. Analysis of staff interviews revealed four main categories: (1) what activities can do; (2) if you build it, they might come; (3) having fun; and (4) importance of staff training and support.

Conclusions: Results suggest that both patients and staff had a number of reactions in response to our behavioural activation intervention. These results are discussed in light of patient–staff relationships and the impact on the patient environment.