Evaluation of a multi-site intervention to reduce and eliminate seclusion and restraint in mental health facilities and programs for adults and children

APHA Scientific Session and Event Listing

Dow A. Wieman, PhD¹, Kevin A. Huckshorn, RN², Paul Wohlford, PhD³, and Teresita Camacho-Gonsalves, PhD¹. (1) Human Services Research Institute, 2336 Massachusetts Ave, Cambridge, MA 02140, 617 876-0426 x2503, dwieman@hsri.org, (2) National Technical Assistance Center, National Association of State Mental Health Program Directors, 66 Canal Center Plaza, Suite 302, Alexandria, VA 22314, (3) Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rm 1-1113, Rockville, MD 20857

The widespread use of seclusion and restraint (s/r) for managing behavior of adults and children receiving mental health treatment is increasingly criticized as infringing upon rights and freedoms, undermining goals of recovery and personal autonomy and causing adverse events including staff and consumer injuries and traumatization. This presentation reports results of an evaluation of the multi-site Substance Abuse and Mental Health Services Administration (SAMHSA) Initiative to Reduce/Eliminate Seclusion and Restraint (S/R) in Mental Health Facilities, which has awarded 8 state mental health agencies with grants to develop best-practice s/r reduction programs in a total 48 adult and child/adolescent facilities. The National Technical Assistance Center (NTAC) of the National Association of State Mental Health Program Directors (NASMHPD) operates a national coordinating center for the project. NTAC is also the developer of the s/r reduction intervention, known as the Six Core Strategies©, which is the basis for the interventions implemented by grantees. The Human Services Research Institute is conducting the evaluation. The evaluation will establish an evidence base, program manual and tested fidelity instrument as required for application to SAMHSA's National Registry of Effective and Promising Practices (NREPP) and subsequent dissemination as an evidence based practice. The evaluation uses a cross-site common protocol with a time-series design to assess the relationship between facility/program characteristics, population characteristics, implementation (fidelity) of the intervention, and outcomes (rates of seclusion/restraint including those for sub-populations of race, gender and age. Two-year quantitative findings of the evaluation will be presented.

Learning Objectives:

At the conclusion of the presentation participants will be able to

1)Identify the adverse consequences of seclusion and restraint in mental health facilities and programs
2)Describe core strategies for reducing and eliminating seclusion and restraint
3)Assess the effectiveness of the strategies as indicated by initial findings.

Keywords: Mental Health Care, Evidence Based Practice

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation

Coercion and Diversion in Mental Health Treatment

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA