The following is a summary of the “No safety without emotional safety,” published in the January 2023 issue of Psychiatry by Veale, et al.

This Personal View emphasizes the importance of emotional safety for a person to be physically safe. They explain how attempting to control behavior to increase physical safety in the short term can have the unintended consequence of reducing emotional safety, which may lead to increased stress and hopelessness. 

They describe these processes using examples from institutions with psychiatric inpatients. They contend that emotional and physical safety cannot be separated and that the absence of emotional safety jeopardizes basic care in an acute crisis and over time. 

Staff who are afraid of being criticized and thus feel compelled to take autonomy and responsibility away from patients unwittingly undermine patients’ experiences of being empathically understood and supported, contributing to patients’ emotional turmoil and lack of safety. A cultural shift and regulatory reform are required to bring psychiatric care more in line with patients’ psychological needs to achieve physical and emotional safety.