Human Factors and Patient Safety: The Normalisation of Deviance in Mental Health Inpatient Healthcare Delivery in the UK: An Homage to Banja (2010)

This article borrows from the conceptual framework outlined by Banja (2010) accounting for the normalisation of deviant practice in healthcare, and applies them to the characteristics of mental health inpatient services. It outlines how Banja’s drivers of normalised deviance apply in such settings and provides an account of why these drivers resist remediation. It proposes a provisional conceptual framework to support the development of a theory and practice evidence base informing the delivery of inpatient mental healthcare, incorporating existing psychological research into human factors in healthcare. A new tool, the Cultural Assessment of Staff Teams, is introduced as a measure potentially supportive of this framework. Finally, it proposes fundamental redesign of the inpatient mental health system and appeals for clinician focus on research into the human factors impacting staff understanding, practice and behaviour alongside existing research into the aetiology, nosology and treatment of mental health problems themselves.