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Open Access 01-12-2024 | Research

The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: a systematic review

Authors: Jessica L. Griffiths, Katherine R. K. Saunders, Una Foye, Anna Greenburgh, Ciara Regan, Ruth E. Cooper, Rose Powell, Ellen Thomas, Geoff Brennan, Antonio Rojas-García, Brynmor Lloyd-Evans, Sonia Johnson, Alan Simpson

Published in: BMC Medicine | Issue 1/2024

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Abstract

Background

The use of surveillance technologies is becoming increasingly common in inpatient mental health settings, commonly justified as efforts to improve safety and cost-effectiveness. However, their use has been questioned in light of limited research conducted and the sensitivities, ethical concerns and potential harms of surveillance. This systematic review aims to (1) map how surveillance technologies have been employed in inpatient mental health settings, (2) explore how they are experienced by patients, staff and carers and (3) examine evidence regarding their impact.

Methods

We searched five academic databases (Embase, MEDLINE, PsycInfo, PubMed and Scopus), one grey literature database (HMIC) and two pre-print servers (medRxiv and PsyArXiv) to identify relevant papers published up to 19/09/2024. We also conducted backwards and forwards citation tracking and contacted experts to identify relevant literature. The Mixed Methods Appraisal Tool assessed quality. Data were synthesised narratively.

Results

Thirty-two studies met the inclusion criteria. They reported on CCTV/video monitoring (n = 13), Vision-Based Patient Monitoring and Management (n = 9), body-worn cameras (n = 6), GPS electronic monitoring (n = 2) and wearable sensors (n = 2). Sixteen papers (50.0%) were low quality, five (15.6%) medium quality and eleven (34.4%) high quality. Nine studies (28.1%) declared a conflict of interest. Qualitative findings indicate patient, staff and carer views of surveillance technologies are mixed and complex. Quantitative findings regarding the impact of surveillance on outcomes such as self-harm, violence, aggression, care quality and cost-effectiveness were inconsistent or weak.

Conclusions

There is currently insufficient evidence to suggest that surveillance technologies in inpatient mental health settings are achieving their intended outcomes, such as improving safety and reducing costs. The studies were generally of low methodological quality, lacked lived experience involvement, and a substantial proportion (28.1%) declared conflicts of interest. Further independent coproduced research is needed to more comprehensively evaluate the impact of surveillance technologies in inpatient settings. If they are to be implemented, all key stakeholders should be engaged in the development of policies, procedures and best practice guidance to regulate their use, prioritising patients’ perspectives.
Appendix
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Metadata
Title
The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: a systematic review
Authors
Jessica L. Griffiths
Katherine R. K. Saunders
Una Foye
Anna Greenburgh
Ciara Regan
Ruth E. Cooper
Rose Powell
Ellen Thomas
Geoff Brennan
Antonio Rojas-García
Brynmor Lloyd-Evans
Sonia Johnson
Alan Simpson
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2024
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-024-03673-9

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