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Table 6 Exemplifying related to protection through dignity and watchfulness

From: Shared understanding of resilient practices in the context of inpatient suicide prevention: a narrative synthesis

Patients

Intermittent observation can make me feel safe, but it depends on how suicidal I am. It does not work if I just want to die and don’t want any help, but it does work when I just don’t want to live, but am not driven by suicidal impulses… But they need to interact with me somehow and ask me how I am doing…. I remember one time I had an observation every 15 min. When they opened the door and looked in, I just felt like they were constantly saying ‘yes, she’s still alive’, and then they left again. Then it loses its purpose because it was okay that they saw I was alive, but no one asked how I was doing. And that is the clue, and they cannot merely act as prison guards

(Female, emotional unstable personality disorder, open rehabilitation ward, sample 2)

Healthcare Professionals

Sometimes, it’s not appropriate to just look in at them. For example, we recently had a man hospitalised who had observations at five-minute intervals. I saw that he had a desire to talk, but then it almost becomes a rejection when you go out again, just to come back after five minutes and go out again. It’s like ‘I just need to check that you’re still alive’. That’s not a worthwhile thing to do. I always try to get them out of the room, so that it becomes less artificial, and I can focus my attention on them. Then the relationship becomes more equal, instead of one-sided.. I bring them out in the living room in the locked unit, but I keep an eye on them. It’s about normalising the situation, because it is not normal to have someone watching you every five minutes. They also need to experience that they do not act on their suicidal impulses

(Male nurse, 1 year of experience, locked ward, sample 3)