Your Body, My Business: Risk Governance in A Psychiatric Nursing Home

Introduction: A crucial long-term care resource for individuals with severe mental illness (SMI) in Taiwan is provided by psychiatric nursing homes. Given the higher incidence of physical illnesses and accidents among individuals with SMI, ensuring patient safety is an important aspect of quality care. However, there is limited literature exploring how the staff provides safe care for individuals with SMI. Aim: Investigates how the staff in a psychiatric nursing home managed residents' activities to mitigate risks and reduce physical injuries. Method: Using a qualitative approach and drawing from Foucault's concept of ‘disciplinary power’, data were collected from field observations and staff interviews. Results: Three themes emerged: (1) a gaze for efficiency, where checklists, timetables and spatial arrangements were used to efficiently manage residents' bodies; (2) controlling the deviant body, which entailed procedures to monitor and prevent risk behaviours and bodily signs through broad safety measures and (3) your body, my business, which described the reduced autonomy of residents over their behaviours as the responsibility largely shifted to the staff. Discussion: The predominant risk management framework, driven by safety considerations, comprises residents' autonomy and undermines compassionate caring. Implications for Practice: Risk management should actively involve both staff and residents in decision-making.