Reducing seclusion and restraint in an acute adolescent psychiatric ward: A feasibility study.

Introduction Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended.