Mutual Expectations is one of 10 interventions within the Safewards program. Safewards is an internationally recognized program that engages both staff and patients in a positive and proactive way to reduce tension and conflict. Click here to learn more about Safewards or continue reading to learn more about Mutual Expectations. 

Clear Mutual Expectations: Both staff and patients have mutual expectations. Sometimes conflicts are a result of disagreement, confusion, misinterpretation, or miscommunication of these expectations. Each unit is asked to meet with patients and staff and create a visible poster with a list of mutual expectations that apply equally to both groups.

Some of the difficult and challenging behaviours exhibited by patients are due in part to lack of clarity about how they are expected to behave, or lack of consistency between the ward staff about what those expectations are. This ambiguity or lack of clarity is particularly problematic for patients who:

  • cannot think clearly
  • are distracted by psychotic thinking and preoccupations
  • find it hard to concentrate
  • have difficulty interpreting the verbal and nonverbal communications of others
  • are undergoing extreme emotional states and moods that bias their perception and interpretation of what is going on around them
  • Have a distorted view of the world and others, particularly those in positions of authority, possibly due to past experience and upbringing.

    These expectations work both ways, and just as the staff have expectations of patients, patients have expectations of the staff. Clarifying these relationships allows the staff to be consistent, and the patients to understand their obligations and those of staff. Communication between the two will be eased, and clarity in the social environment will assist patients to think more clearly, and experience less irritation and frustration. Lowered stress and anxiety help to reduce symptoms and aid patients' recovery.



    Step 1: Hold a staff meeting to discuss what expectations staff would like

    Step 2: Hold a community meeting with the staff and patients, circulate the list of suggestions, and determine with the patients present what should be included in the commitments of staff and patients, as well as which are the most important.  At the close of the meeting, agree the final list and contents, and choose a design format for these to be printed up. .

    Step 3: Type up your agreed list of mutual expectations and have your mutual expectations printed as a laminated poster to the unit, to your specified design with your specified content. Please hang this in a prominent and public space where it can be read by patients and staff.

     Step 4: Make the poster part of the admission process, going though it with new patients, perhaps several times over the first week, making sure they understand the contents.