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Psychiatrists’ engagement in Safewards relied on leadership, role clarity, and organizational support.  

The qualitative exploratory study, published in June 2025 in the issue of BMC Psychiatry, examined psychiatrists’ limited engagement in implementing the Safewards model despite its potential to reduce restrictive practices that carries significant risks of injury and trauma in psychiatric inpatient settings.  

Researchers identified key facilitators, behaviors, and barriers to psychiatrists’ involvement in implementing Safewards and other quality improvement initiatives.  

They used semi-structured interviews and inductive content analysis, 10 psychiatrists from 9 psychiatric clinics in Sweden were recruited through convenience sampling. Clinics offered both voluntary and involuntary care and had varying levels of Safewards implementation. Participants, evenly split by gender, had an average of 12 years of experience. Interviews were held in person or digitally, lasted 30–90 minutes, and were transcribed verbatim. Data were analyzed collaboratively using qualitative content analysis to maintain coding consistency. Reflexive methods and the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist supported the study’s trustworthiness.  

The results showed that psychiatrists’ participation in Safewards and quality improvement activities was shaped by their professional identity and clinical setting. Leadership roles, specialized training, and observed improvements in communication with staff and individuals receiving care supported engagement. Barriers comprised a limited clinical focus, detachment from comprehensive care, and the unpredictable demands of psychiatric duties. Time constraints, competing priorities, and local management support also influenced involvement.  

Investigators concluded that psychiatrists’ engagement in Safewards was shaped by leadership, clinical focus, and time availability. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-07058-x