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Table 1 Summary of long stay stances

From: The experience of long stay in high and medium secure psychiatric hospitals in England: qualitative study of the patient perspective

ThemeLong stay stance
Dynamic acceptance (14 participants)Static acceptance (12 participants)Dynamic resistance (nine participants)Static resistance (five participants)
OutlookPositive outlook towards being in secure care; believed their mental health had improved whilst in secure carePositive outlook towards being in secure care; believed their mental health had improved whilst in secure careNegative outlook towards being in secure care; feeling bored, restricted and frustratedNegative outlook towards being in secure care; feeling bored, suffocated and a sense of pointlessness
ApproachProactive approach; stressed the importance of keeping busy and making the most of their time by engaging in occupational activities and therapiesProactive approach to occupational activities; less willing to take part in therapies that they found ineffectiveProactive approach to engaging in occupational activities and therapies that, although thought repetitive and pointless, would ultimately help them to move onPassive approach to daily life; choosing not to engage in any occupational activities or therapies
Attribution (for their long stay)Being unwell; their own behaviourTheir own behaviour; being on the wrong medication; being in a non-therapeutic environmentRisk-averse factors that left them feeling unable to prove themselves to staffInterpersonal and structural factors outside their control
Readiness for changeBelieved that they did not need to be in secure care; felt ready to move on to lower secure unitsBelieved that they were not ready to move on from their current unitBelieved that they did not need to be in their current unit but were stuckBelieved that they did not need to be in secure care but that they had no choice and so chose to remain