Inpatient psychiatric units are often the first point of stabilization for individuals in crisis, many of whom are experiencing acute anxietFy or depression. Standard treatment models include group therapy, individual sessions with psychiatrists and therapists, medication management, psychoeducational groups, and activity-based interventions. While these approaches form the backbone of care, consistent socialization, staff engagement and peer-to-peer connections can be vital to recovery.
Recent studies highlight that intentional staff rounding, structured, scheduled check-ins with patients improves safety, and increased engagement can reduce the length of stay. Similarly, peer support, whether organically occurring or built into group formats, has been shown to enhance coping skills, reduce isolation, and contribute to better mental health outcomes.
The Value of Intentional Rounding
Intentional Rounding (IR) refers to systematic, scheduled visits by staff for each patient, typically at 15-, 30-, or 60- minute intervals. Originating in acute units, IR has demonstrated clear benefits such as increased patient satisfaction, improved safety, and enhanced communication between staff and patients (Brosey & March 2015; Sims et al., 2018).
In psychiatric care, this IR practice takes on additional importance. Patients who are admitted in crisis often require close monitoring to ensure safety. Regular rounding not only confirms wellbeing but also creates opportunities for therapeutic interaction. Staff observing behavioral patterns during these checks can often detect subtle changes, such as withdrawal from activities or changes in mood, well before they escalate into safety concerns. This proactive approach allows for earlier intervention and reduces the likelihood of sentinel and non-sentinel events.
From a nursing perspective, IR is not just a box to be checked. It allows staff to build rapport, demonstrate presence, and show patients that they are consistently supported. Over time, these interactions strengthen trust and improve engagement with formal treatment modalities like group therapy and individual counseling.
Peer Support in Psychiatric Units
Alongside staff engagement, peer-to-peer interaction plays an important role in patient recovery. Research shows that patients in inpatient units naturally support one another through shared experiences, advice, companionship, and empathy (Kogstad, Monness, & Sorensen, 2013). These connections often help patients feel less isolated and more hopeful about recovery.
Formalized peer support, such as structured group therapy, further builds on this foundation. Group settings provide opportunities to develop social skills, learn coping strategies, and recognize commonalities with others. Yalom’s therapeutic factors, such as universality, altruism, and the instillation of hope, are well documented benefits of group psychotherapy (Yalom & Leszcz, 2020).
Recent systematic reviews confirm that peer support can improve recovery and psychosocial outcomes, particularly among younger populations experiencing anxiety and depression (Lawn et al., 2008; Brown et al., 2023). While peer interaction does not replace evidence-based treatment, it meaningfully complements it by reinforcing engagement and reducing feelings of loneliness.
Even environmental design reflects this principle: many psychiatric units avoid placing patients in private rooms unless necessary, recognizing that shared spaces reduce isolation and encourage natural peer interaction.
The Role of Education and Monitoring
Staff engagement is most effective when paired with education and awareness. Staff in psychiatric settings often lead educational groups on topics like stress management, nutrition, medication adherence, and coping strategies. These sessions not only deliver practical knowledge but also create opportunities for patients to ask questions and strengthen their sense of agency in recovery.
In addition to structured teaching, routine in person rounding gives staff valuable insight into patient progress. Attendance at group therapy, participation in activities, and engagement with peers are all observable behaviors that can indicate how well a patient is responding to treatment. When staff notice patterns, such as a patient skipping multiple group therapies, they can intervene early, providing additional support or adjusting rounding frequency to ensure safety and wellbeing.
This dual role of educator and observer reinforces the therapeutic alliance. Patients see staff not only as safety monitors, but also as partners in recovery who provide guidance, encouragement, and timely interventions. In turn, staff gain deeper understanding of patient needs, allowing them to tailor care with greater prevision.
Combining Staff and Peer Engagement
When intentional staff rounding and peer socialization are implemented together, they create a comprehensive support system. Staff engagement ensures safety, consistency, and individualized attention, while peer interaction fosters empathy and shared resilience.
For example, a patient who misses group therapy may be identified through staff rounding. Rather than allowing disengagement to go unnoticed, the staff member can provide additional support, encourage participation, or explore barriers to involvement. This blend of oversight and encouragement reinforces accountability while showing compassion.
In this way, staff engagement and peer connection are not separate strategies but complementary forces that promote recovery and wellbeing.
Technology as a Supportive Resource
Although patient care is rooted in human interaction, technology can strengthen the consistency and reliability of engagement practices. A safety platform such as ObservSMART offers proximity-required rounding, structured reminders and alerts, and easy-to-use documentation features that help staff maintain in person timely rounds and easily note behavioral observations in real-time.
By reducing the risk of missed check-ins, supporting staff engagement, and providing data that highlights changes in behavior or therapy attendance, this technology acts as a safety net. Technology does not replace the personal element of staff to patient interaction – it enables staff to sustain consistent, high-quality engagement and patient safety.
Outcomes of Engagement Practices
Research and frontline experience show that staff engagement and peer connection lead to several measurable outcomes in psychiatric care:
- Shorter lengths of stay: Patients who are consistently engaged tend to progress more quickly through treatment.
- Higher patient satisfaction: Regular, meaningful contact reassures patients and improves their overall experience of care.
- Improved safety: Frequent observations allow for early detection of risk behaviors or mood deterioration, enabling timely interventions.
- Enhanced psychosocial recovery: Peer connections reduce isolation, foster coping skills, and reinforce treatment gains.
These benefits highlight the importance of viewing engagement not as an optional addition to care, but as a core element of effective psychiatric treatment.
Conclusion
For patients admitted with acute anxiety or depression, the inpatient psychiatric units are more than a place of safety, it’s a space where healing is nurtured through connection. Intentional rounding by staff and the promotion of peer interaction contribute significantly to patient wellbeing, complementing formal therapies and medical management.
By blending technology, structured staff rounding and engagement, with opportunities for peer support, psychiatric units create environments where patients feel seen, supported, and empowered in their recovery. Genuine human connection, process, and technology can play a supportive role in sustaining psychiatric care practices.
For additional information regarding ObservSMART, visit our website: https://www.observsmart.com/learn-more/.
References
Brosey, L.A., & March, K. K. (2015) Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 30(2), 153-159.
Brown, C., Wright, C., & Zubrick, S. (2023). Peer support interventions for young people with anxiety and depression: A systematic review. BMC Psychiatry, 23(1), 45.
Kogstad, R.E., Monness, E., & Sorensen, T. (2013). Social networks for mental health clients: Resources and solution. International Journal of Mental Health Systems, 7(1), 1.
Lawn, S., Smith, A., & Hunter, K. (2008). Mental health peer support for hospital avoidance and early discharge. International Journal of Mental Health Nursing, 17(5), 324-331.
Sims, S., Leamy, M., Davies, N., Schnitzler, K., Levenson, R., Mayer, F., & Ross, F. (2018). Realist synthesis of international rounding in hospital wards: Exploring the evidence of what works, for whom, and in what circumstances. BMJ Quality & Safety, 27(9), 743-757.
Yalom, I.D., Leszcz, M. (2020). The Theory and Practice of Group Psychotherapy (6th ed.). Basic Books.
