A definition of relational security within forensic mental health care: a scoping review and content analysis

Relational security is an increasingly used concept in forensic mental health practice, where an equal working relationship for de-escalation and prevention of aggression and violence is emphasized. However, there is no uniform definition of relational security. The aim of this paper is to gain more insight into the existing definitions of relational security. In this scoping review, 34 definitions of relational security were found. After thematic analysis, the following themes emerged, representing different elements within these themes: a. what relational security is on a conceptual level and the context it relates to, b. the core components of relational security and to whom it applies, c. bringing relational security into practice, and d. objectives of relational security. The content analysis shows many variations between existing definitions, which makes it impossible to provide a common definition based on this study. However, certain elements such as the relationship between staff and patients, knowledge about the patients, and risk assessment were reasonably consistent throughout the definitions. This study highlights the necessity to further explore the distinctive components of relational security and reach consensus on an overall definition that is useful for (training in) the psychiatric forensic and prison-like settings.