Psychiatr News July 7, 2006
Volume 41, Number 13, page 9
© 2006 American Psychiatric Association
Government Includes Consumer Input In Seclusion, Restraint Curriculum
Rich Daly
"Consumer-developed" guidelines aim to help mental health
facilities train staff in alternatives to seclusion and restraint.
Former patients of mental health facilities who were subjected to seclusion
and restraint assisted in the development of first-of-their-kind guidelines
recently released by the Substance Abuse and Mental Health Services
Administration (SAMHSA).
Described as a "training curriculum" for mental health
clinicians, the guidelines are designed to teach "prevention
strategies" and alternative approaches to avoid and reduce the use of
seclusion and restraint.
"A Roadmap to Seclusion- and Restraint-Free Mental Health Services
for Persons of All Ages" emphasizes the need to create cultural change
within mental health facilities to reduce the use of seclusion and
restraint.
"This is the first training curriculum of its sort developed by a
federal agency for direct-care staff as a means of reducing or preventing
these practices," Paolo del vecchio, SAMHSA's associate director for
consumer affairs, told Psychiatric News.
The curriculum lays out specific strategies, including self-care
approaches, peer-provided services, arts programs, and comfort rooms. Other
approaches include use of advance directives, mediation, service animals, and
better communication approaches.
The curriculum was developed for SAMHSA by the National Association of
Consumer/Survivor Mental Health Administrators and combines input from mental
health consumers and best practices described by mental health organizations
nationwide. Research used to create the curriculum included that of Gayle
Bluebird, R.N., who studied the use of comfort rooms as a preventive tool to
reduce the need for seclusion and restraint at Atlantic Shores Hospital in
Florida.
Final recommendations were pilot tested in two hospitals prior to
publication. The pilot programs found that the curriculum contributes to steep
reductions in the use of seclusion and restraint, to the extent that one
hospital permanently removed the door of its seclusion room, said del
vecchio.
State and federal laws and regulations have increasingly aimed to curb the
use of seclusion and restraint for mental health care recipients. Among these
laws is the Children's Health Act of 2000, which set standards for federally
funded health care facilities and nonmedical residential facilities for
children.
The curriculum can be ordered in CD-ROM format through SAMHSA's
National Mental Health Information Center at
<www.mentalhealth.samhsa.gov>
or by phone at (800) 789-2647. The curriculum is posted at
<www.mentalhealth.samhsa.gov/publications/allpubs/sma064055/>.
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