Lived experiences of mental healthcare professionals facing patients in crisis with challenging behaviors: a phenomenological study
DOI:
https://doi.org/10.33361/RPQ.2026.v.14.n.39.1409Keywords:
Coercion, Violence, Psychiatry, Mental Health Care, PhenomenologyAbstract
This study aimed to describe mental healthcare professionals’ lived experiences in the face of psychiatric crises marked by challenging or aggressive behaviors. Drawing on Amedeo Giorgi’s phenomenological method, 12 professionals from a Psychosocial Care Center III in Brazil were interviewed. The findings reveal six essential constituents of the experience: Disruption of daily life; immediate affect; words as ethical gestures; questioning of a caregiver’s humanity; inflection in the bond; and tension between vocation and exhaustion. The analysis revealed that the crisis is not merely a clinical event, but an affective and ethical experience that permeates professionals in their corporeality, affectivity, and identity. The study emphasizes the affective, ethical, and existential dimensions of psychiatric crisis care, reaffirming that mental healthcare is also burdensome for those who provide it, and underscoring the importance of caring for caregivers.
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AMARANTE, P.; NUNES, M. de O. A reforma psiquiátrica no SUS e a luta por uma sociedade sem manicômios. Ciência & Saúde Coletiva, Rio de Janeiro, v. 23, n. 6, p. 2067–2074, jun. 2018. DOI: https://doi.org/10.1590/1413-81232018236.07082018
AVANCI, R. de C.; MALAGUTI, S. E.; PEDRÃO, L. J. Autoritarismo e benevolência frente à doença mental: estudo com alunos ingressantes no curso de enfermagem. Revista Latino-Americana de Enfermagem, Ribeirão Preto, v. 10, n. 4, p. 509–515, jul. 2002. DOI: https://doi.org/10.1590/S0104-11692002000400007
BIGWOOD, S.; CROWE, M. ‘It’s part of the job, but it spoils the job’: a phenomenological study of physical restraint. International Journal of Mental Health Nursing, Hoboken, NJ, v. 17, n. 3, p. 215–222, maio. 2008. DOI: https://doi.org/10.1111/j.1447-0349.2008.00526.x
BOWERS, L.; ALEXANDER, J.; BILGIN, H.; BOTHA, M.; DACK, C.; JAMES, K.; JARRETT, M.; JEFFERY, D.; NIJMAN, H.; OWITI, J. A.; PAPADOPOULOS, C.; ROSS, J.; WRIGHT, S.; STEWART, D. Safewards: the empirical basis of the model and a critical appraisal. Journal of Psychiatric and Mental Health Nursing, Hoboken, NJ, v. 21, n. 4, p. 354–364, jan. 2014. DOI: https://doi.org/10.1111/jpm.12085.
BOWERS, L. Safewards: a new model of conflict and containment on psychiatric wards. Journal of Psychiatric and Mental Health Nursing, Hoboken, NJ, v. 21, n. 6, p. 499–508, fev. 2014. DOI: https://doi.org/10.1111/jpm.12129
BOWERS, Len; JAMES, Karen; QUIRK, Alan; SIMPSON, Alan; SUGAR; STEWART, Duncan; HODSOLL, John. Reducing conflict and containment rates on acute psychiatric wards: the Safewards cluster randomised controlled trial. International Journal of Nursing Studies, Oxford, v. 52, n. 9, p. 1412–1422, set. 2015. DOI: https://doi.org/10.1016/j.ijnurstu.2015.05.001
CHANG, Y. C.; HSU, M. C.; OUYANG, W. C. Effects of integrated workplace violence management intervention on occupational coping self-efficacy, goal commitment, attitudes, and confidence in emergency department nurses: a cluster-randomized controlled trial. International Journal of Environmental Research and Public Health, Basel, v. 19, n. 5, p. 2835, fev. 2022. DOI: https://doi.org/10.3390/ijerph19052835
DELL’ACQUA, G.; MEZZINA, R. Resposta à crise: estratégia e intencionalidade da intervenção no serviço psiquiátrico territorial. In: AMARANTE, P. (org.). Archivos de saúde mental e atenção psicossocial. Rio de Janeiro: Nau, 2005. p. 161–194.
DRACH-ZAHAVY, A.; GOLDBLATT, H.; GRANOT, M.; HIRSCHMANN, S.; KOSTINTSKI, H. Control: patients’ perspectives on mental health nurses’ responses to challenging behaviours. Qualitative Health Research, Thousand Oaks, v. 22, n. 1, p. 43–53, jul. 2011. Disponível em: https://doi.org/10.1177/1049732311414730. Acesso em: 17 maio 2025.
FERIGATO, S. H.; CAMPOS, R. T. O.; BALLARIN, M. L. G. S. O atendimento à crise em saúde mental: ampliando conceitos. Revista de Psicologia da UNESP, Assis, v. 6, n. 1, p. 31–44, mar. 2007. Disponível em: https://revpsico-unesp.org/index.php/revista/article/view/37. Acesso em: 16 jun. 2022.
GIORGI, A.; SOUSA, D. A. Método fenomenológico em psicologia. Lisboa: Fim de Século, 2010.
GOODING, P.; MCSHERRY, B.; ROPER, C. Preventing and reducing ‘coercion’ in mental health services: an international scoping review of English-language studies. Acta Psychiatrica Scandinavica, Hoboken, NJ, v. 142, n. 1, p. 27–39, jan. 2020. DOI: https://doi.org/10.1111/acps.13152
HAUGVALDSTAD, M. J.; HUSUM, T. L. Influence of staff’s emotional reactions on the escalation of patient aggression in mental health care. International Journal of Law and Psychiatry, Oxford, v. 49, pt. A, p. 130–137, dec. 2016. DOI: https://doi.org/10.1016/j.ijlp.2016.09.001
HUSSERL, E. Ideias para uma fenomenologia pura e para uma filosofia fenomenológica: introdução geral à fenomenologia pura. Tradução de Marcio Suzuki. 2ª Edição. São Paulo: Ed. Ideias & Letras, 2006.
HUSUM, T. L.; THORVARSDOTTIR, V.; AASLAND, O.; PEDERSEN, R. “It comes with the territory”: staff experience with violation and humiliation in mental health care – a mixed method study. International Journal of Law and Psychiatry, Oxford, v. 71, p. 101610, jul.-ago. 2020. DOI: https://doi.org/10.1016/j.ijlp.2020.101610
JALIL, R.; DICKENS, G. L. Systematic review of studies of mental health nurses’ experience of anger and of its relationships with their attitudes and practice. Journal of Psychiatric and Mental Health Nursing, Cidade da revista, v. 25, n. 3, p. 201–213, 2018. DOI: https://doi.org/10.1111/jpm.12450
JALIL, R.; HUBER, J. W.; SIXSMITH, J.; DICKENS, G. L. Mental health nurses’ emotions, exposure to patient aggression, attitudes to and use of coercive measures: cross sectional questionnaire survey. International Journal of Nursing Studies, Oxford, v. 75, p. 130–138, out. 2017. DOI: https://doi.org/10.1016/j.ijnurstu.2017.07.018
KORELC, M. Doação e ser. Educação e Filosofia, Uberlândia, v. 30, n. esp., p. 63–86, dez. 2016. DOI: https://doi.org/10.14393/REVEDFIL.issn.0102-6801.v30nEspeciala2016-p62a86
LEVINAS, E. Totalidade e infinito: ensaio sobre a exterioridade. Tradução de José Pinto Ribeiro. Revisão de Artur Morão. Lisboa: Edições 70, 1980.
MERLEAU-PONTY, M. Fenomenologia da percepção. Tradução de Carlos Alberto Ribeiro de Moura. 2. ed. São Paulo: Martins Fontes, 1999.
MESSAS, G.; FUKUDA, L. O diagnóstico psicopatológico fenomenológico da perspectiva dialético-essencialista. Revista Pesquisa Qualitativa, São Paulo, v. 6, n. 11, p. 160–191, ago. 2018. DOI: https://doi.org/10.33361/RPQ.2018.v.6.n.11.189
NEEDHAM, I.; ABDERHALDEN, C.; HALFENS, R. J. G.; FISCHER, J. E.; DASSEN, T. Non-somatic effects of patient aggression on nurses: a systematic review. Journal of Advanced Nursing, Hoboken, NJ, v. 49, n. 3, p. 283–296, jan. 2005. DOI: https://doi.org/10.1111/j.1365-2648.2004.03286.x
PREFEITURA DE BELO HORIZONTE. Rede de Atenção Psicossocial de Belo Horizonte (RAPS-BH): política de saúde mental em BH. Belo Horizonte: PBH, 2018. Disponível em: https://prefeitura.pbh.gov.br/saude/informacoes/atencao-a-saude/saude-mental. Acesso em: 2 nov. 2022.
RICHMOND, J. S.; BERLIN, J. S.; FISHKIND, A. B.; HOLLOMAN JUNIOR, G. H.; ZELLER, S. L.; WILSON, M. P.; RIFAI, M. A.; NG, A. T. Verbal de-escalation of the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup. Western Journal of Emergency Medicine, Orange, CA, v. 13, n. 1, p. 17–25, fev. 2012. DOI: https://doi.org/10.5811/westjem.2011.9.6864
SCHABLON, A.; WENDELER, D.; KOZAK, A.; NIENHAUS, A.; STEINKE, S. Prevalence and consequences of aggression and violence towards nursing and care staff in Germany: a survey. International Journal of Environmental Research and Public Health, Basel, v. 15, n. 6, p. 1274, mai. 2018. DOI: https://doi.org/10.3390/ijerph15061274
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