Online video games and patient–staff power relations. A qualitative study of care and custody in forensic psychiatry

Introduction

In recovery-oriented care, forensic psychiatric nurses must engage in care relationships with patients (FPs) while focusing on ward security. Online video games (OVG) may provide a platform for negotiating power and social relations. Studies showing how OVG interventions may influence power balances in forensic psychiatric care are needed to guide clinical practice. 

Aim

To study how power relations were articulated between FPs and staff in an OVG intervention in a Danish forensic psychiatric ward. 

Method

Data consists of three months of observational data and interviews with three staff members and six patients. We used sociologist Pierre Bourdieu’s framework of field, power, and capital to analyze data. 

Results

The OVG intervention consists of two power fields, “in-game” and “over-game.” In-game concerned the practice of gaming. Over-game described the organization of the gaming intervention. Specific logics, skills, and symbolic capitals drove power in each field. 

Discussion

Power in-game was open to FPs and staff, leading to symmetric power relations. Power over-game was open to staff only, resulting in asymmetrical power relations. 

Implications for practice

OVG interventions may facilitate power balancing in forensic psychiatry. These insights may guide the development of new OVG interventions for patients and nurses in mental health care.