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Interventions for reducing the use of seclusion in psychiatric facilities : a review of the literature
journal contribution
posted on 2007-01-01, 00:00 authored by Cadeyrn GaskinCadeyrn Gaskin, S Elsom, B HappellBackground The authors of a recent systematic review concluded that the use of non-pharmacological containment methods, excluding restraint and seclusion, was not supported by evidence. Their focus on randomised, controlled trials, however, does not reflect the research that has been, or could be, conducted.
Aims To find empirically supported interventions that allow reduction in the use of seclusion in psychiatric facilities.
Method We reviewed English-language, peer-reviewed literature on interventions that allow reduction in the use of seclusion.
Results Staff typically used multiple interventions, including state-level support, state policy and regulation changes, leadership, examinations of the practice contexts, staff integration, treatment plan improvement, increased staff to patient ratios, monitoring seclusion episodes, psychiatric emergency response teams, staff education, monitoring of patients, pharmacological interventions, treating patients as active participants in seclusion reduction interventions, changing the therapeutic environment, changing the facility environment, adopting a facility focus, and improving staff safety and welfare.
Conclusions Reducing seclusion rates is challenging andgenerally requires staff to implement several interventions.
Aims To find empirically supported interventions that allow reduction in the use of seclusion in psychiatric facilities.
Method We reviewed English-language, peer-reviewed literature on interventions that allow reduction in the use of seclusion.
Results Staff typically used multiple interventions, including state-level support, state policy and regulation changes, leadership, examinations of the practice contexts, staff integration, treatment plan improvement, increased staff to patient ratios, monitoring seclusion episodes, psychiatric emergency response teams, staff education, monitoring of patients, pharmacological interventions, treating patients as active participants in seclusion reduction interventions, changing the therapeutic environment, changing the facility environment, adopting a facility focus, and improving staff safety and welfare.
Conclusions Reducing seclusion rates is challenging andgenerally requires staff to implement several interventions.
History
Journal
British journal of psychiatryVolume
191Pagination
298 - 303Publisher
Royal College of PsychiatristsLocation
London, EnglandPublisher DOI
ISSN
0007-1250eISSN
1472-1465Language
engPublication classification
C1.1 Refereed article in a scholarly journal; C Journal articleCopyright notice
2007, The Royal College of PsychiatristsUsage metrics
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