Evaluation of seclusion and restraint reduction programs in mental health: A systematic review

Publication date: Available online 26 January 2017
Source:Aggression and Violent Behavior
Author(s): Marie-Hélène Goulet, Caroline Larue, Alexandre Dumais
ContextThe effectiveness of seclusion and restraint (SR) reduction programs has not been well established.ObjectiveTo examine the effectiveness of SR reduction programs in mental health settings.Data sourcesA systematic review of English and French articles, using CINALH, Web of Science, PubMed, Medline, Embase, and the Cochrane Library. Additional studies were added by searching the references of identified papers.Study selectionAll evaluative studies on SR reduction programs in mental health were included based on predefined criteria (n=23 articles).Data extractionData extraction of articles was performed using predefined data fields. The three authors conducted quality assessments independently.Data synthesisIn the 23 articles analyzed, six key components were predominant in SR reduction programs: 1) leadership, 2) training, 3) post-seclusion and/or restraint review, 4) patient involvement, 5) prevention tools, and 6) the therapeutic environment.ConclusionDespite wide variability in SR indicators and methodological rigor, it remains that the outcomes argue in favor of SR reduction program implementation.



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