Interventions To Reduce the Use of Seclusion and Restraint in Inpatient Psychiatric Settings: What We Know So Far a Review of the Literature

Justin Newton Scanlan
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Justin Newton Scanlan: Level 1 Administration, Concord Centre for Mental Health, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia, justin.scanlan@email.cs.nsw.gov.au, Sydney South West Area Health Service and Faculty of Health Sciences, University of Sydney

International Journal of Social Psychiatry, 2010, vol. 56, issue 4, 412-423

Abstract: Introduction: In recent times, much attention has been focused on the reduction of seclusion and restraint in psychiatric settings. This paper analyzes evidence available from evaluations of single seclusion and/or restraint reduction programmes. A total of 29 papers were included in the review. Results: Seven key strategy types emerged from the analysis: (i) policy change/ leadership; (ii) external review/debriefi ng; (iii) data use; (iv) training; (v) consumer/ family involvement; (vi) increase in staff ratio/crisis response teams; and (vii) programme elements/changes. Outcomes indicate that a range of reduction programmes are successful in reducing the frequency and duration of seclusion and restraint use, while at the same time maintaining a safe environment. Conclusion: The development of new seclusion and restraint reduction programmes should include strong leadership from local management; external seclusion and restraint review committees or post-incident debriefing and analysis; broad-based staff training and programme changes at a local level. Behavioural and cognitive-behavioural programmes appear to be very useful in child and adolescent services. Further systematic research should be conducted to more fully understand which elements of successful programmes are the most powerful in reducing incidents of seclusion and restraint.

Keywords: seclusion; restraint; inpatient psychiatry; aggression management; literature review (search for similar items in EconPapers)
Date: 2010
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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:56:y:2010:i:4:p:412-423

DOI: 10.1177/0020764009106630

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