his article discusses ‘special observation’, a practice used in inpatient units and in mental health and learning disability services. I present some perspectives on this practice from women detained on locked wards, and staff members. Despite the many valid criticisms, I show that constant observations can be used as a way to harness engagement and to improve relationships between staff and residents.

Points of interest
Special observation is used in services when a resident is at risk of harm. It means that staff need to watch a resident all the time.

I talked to women with learning disabilities and/or autism who lived in a secure unit.

They told me they did not like being watched all the time, and they wanted their privacy in the bathroom above all.

Some women told me that special observation is better when the staff talk to them and do activities with them. It is better when staff do not stare at them in the bathroom.

I show that it is important to keep people safe. Special observation can be used in positive ways to do this.