INTERVENTIONS TO REDUCE THE USE OF SECLUSION AND RESTRAINT IN INPATIENT PSYCHIATRIC SETTINGS: WHAT WE KNOW SO FAR A REVIEW OF THE LITERATURE

被引:103
作者
Scanlan, Justin Newton [1 ]
机构
[1] Concord Repatriat Gen Hosp, Concord Ctr Mental Hlth, Concord, NSW 2139, Australia
关键词
seclusion; restraint; inpatient psychiatry; aggression management; literature review; SPECIAL SECTION; IMPACT; CHILD;
D O I
10.1177/0020764009106630
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
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/debriefing; (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.
引用
收藏
页码:412 / 423
页数:12
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