Af Nadine B. Høyer, specialsygeplejerske i psykiatrisk sygepleje, kandidat i pædagogisk psykologi, selvstændig psykoterapeut, supervisor og underviser. nadinebenike@gmail.com
Resumé
Baggrund
Artiklen bygger på et kvalitativt studie udført i forbindelse med et kandidatspeciale i pædagogisk psykologi fra 2025. I studiet blev det undersøgt hvordan arbejdsvilkår på psykiatriske døgnafsnit præger personalets mulighed for mentalisering og resonans, samt hvilken betydning dette har for både patientbehandling og arbejdsmiljø.
Metode
Ni dags deltagerobservation og samtaler med ledere, personale og patienter på to psykiatriske døgnafsnit med integreret åben/lukket funktion i Region Syddanmark. Empirien blev analyseret via en kritisk hermeneutisk analyse forankret i mentaliseringsteorien og resonansteorien.
Resultater
Studiets fund viser fire centrale områder som svækker fagligheden, udfordrer praksis og øger non-metalisering og fremmedgørelse:
- Accelereret praksis
- Affektivt pres
- Fravær eller fragmentering af faglighed
- Fysisk skade og psykisk udmattelse
Konklusion
Fundende truer både behandlingskvaliteten og trivslen i en sådan grad, at psykiatrisk døgnbehandling mister sin bæredygtighed. På den baggrund har psykiatrisk døgnafsnit brug for rammer, hvor supervision, debriefing og faglig refleksion prioriteres som uundværlige dele af arbejdet. Det fordrer dybere faglighed, tid og ledere, der går forrest som rollemodeller og skaber en kultur, hvor affekter og relationer anerkendes som meningsfulde og med et udviklingspotentiale.
English abstract
Developing or dismantling psychiatry? How do staff working conditions shape treatment and the working environment in inpatient psychiatric wards – and what does this mean for patients and staff?
Background
This article is based on a qualitative study conducted as part of a Master’s thesis in Educational Psychology in 2025. The study explored how working conditions in inpatient psychiatric wards influence staff’s capacity for mentalisation and resonance, and how this in turn affects both patient care and the working environment.
Method
Nine days of participant observation and conversations with managers, staff, and patients were carried out in two inpatient psychiatric wards with integrated open/closed functions in the Region of Southern Denmark. The empirical material was analysed using a critical hermeneutic approach grounded in mentalisation theory and resonance theory.
Results
The study identified four central areas that weaken professionalism, challenge practice, and increase non-mentalisation and alienation:
1. Accelerated practice
2. Affective pressure
3.Absence or fragmentation of professionalism
4. Physical harm and psychological exhaustion
Conclusion
The findings threaten both quality of care and staff wellbeing to such an extent that inpatient psychiatric treatment risks becoming unsustainable. In light of this, inpatient psychiatric wards need frameworks in which supervision, debriefing, and professional reflection are prioritised as indispensable parts of the work. This requires deeper professional grounding, time, and leaders who act as role models and cultivate a culture in which affects and relationships are recognised as meaningful and holding developmental potential.
Keywords: Inpatient psychiatry, working conditions, mentalisation, resonance, staff wellbeing, quality of care, qualitative study.
Vil du læse videre?
Få adgang til artiklen med:
Enkelt køb af artikel
- Allerede abonnent?
