98%
921
2 minutes
20
Objective: Despite a call for the reduction and ultimate elimination of the use of seclusion and restraint, research on reduction of these practices in behavioral programs has been limited. This study sought to examine the effectiveness of a modified version of the Positive Behavioral Interventions and Supports (M-PBIS) implemented in a youth psychiatric inpatient unit to reduce use of seclusion and restraint.
Methods: This naturalistic, prospective study covered a four-year period (1,485 admissions).
Results: The number of seclusion and restraint events, mean duration of events, and percentage of patients placed in seclusion or restraint were reduced, as was the overall seclusion rate for the unit. Furthermore, there was a significant reduction in the use of pro re nata (PRN) medications for agitation.
Conclusions: These findings suggest that M-PBIS is a promising intervention to use in youth psychiatric inpatient units to reduce seclusion and restraint and PRNs.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1176/appi.ps.201500039 | DOI Listing |
Indian J Psychiatry
August 2025
Department of Psychiatry, AIIMS, New Delhi, India.
Background: Coercive interventions may be required during psychiatric in-patient care, but require careful monitoring to minimize inappropriate use.
Aim: In this article, we aimed to systematically review published literature on the frequency and patterns of selected coercive methods in mental health establishments (MHEs) in India.
Methods: From a systematic screening of four databases (MEDLINE, EMBASE, CINAHL and PSYCINFO) supplemented by searching relevant citations and selected journals, we retrieved studies of frequency and patterns of mechanical restraint, chemical restraint and seclusion at Indian MHEs.
Issues Ment Health Nurs
September 2025
Faculty of Health, Southern Cross University, Coffs Harbour, Australia.
Understanding the drivers of seclusion and physical restraint supports the work towards minimising their use in acute mental health units. However, evidence on their most important drivers remains limited and is focused mainly on individual-level features. Employing 249 days of 917 contemporaneous records of nurse de-escalation events in one adult inpatient unit in regional Australia, from January 2019 to March 2020, twenty-three features other than individual demographic, dispositional, and diagnostic factors were extracted.
View Article and Find Full Text PDFBMJ Open Qual
September 2025
Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK.
Background: Restrictive practices (ie, physical restraint, rapid tranquilisation and seclusion) are used to manage risk of harm to self and/or others during inpatient psychiatric admissions. Restrictive practices can be physically and psychologically hazardous for both patients and staff, but there have been few well-controlled evaluations of interventions to reduce restrictive practices.
Objective: To conduct a controlled evaluation of the implementation of a culture change intervention on a psychiatric intensive care unit (PICU) compared with a control PICU on use of restraint.
Evid Based Pract Child Adolesc Ment Health
November 2024
Johns Hopkins Medicine, Baltimore, MD.
Background: The increasing demand for acute inpatient psychiatric unit (IPU) treatment for children and adolescents in recent years has put significant pressure on hospital systems to provide efficient and effective care. However, there is a gap in the literature regarding the characteristics of IPU care for children and adolescents in the US, making it difficult for institutions to benchmark their performance against nationwide standards or understand generalizability of existing research.
Objective: To address this gap in the literature by beginning to collect descriptive data on significant variables for youth care from a geographically and institutionally diverse group of on Child and Adolescent IPUs.
Trauma Violence Abuse
August 2025
Lifespan & Population Health, School of Medicine, University of Nottingham, UK.
Restrictive practices such as restraints, seclusion, and forced medication are only intended to be used when the threat is at a level whereby an individual is likely to inflict harm on themselves or another individual. Demographic variations, including ethnicity, may be associated with the use of these practices. However, there is no systematic review on patient ethnicity specifically.
View Article and Find Full Text PDF