Consumers’ and their supporters’ perspectives on barriers and strategies to reducing seclusion and restraint in mental health settingsLisa M. Brophy A B , Catherine E. Roper C , Bridget E. Hamilton D E , Juan José Tellez F I and Bernadette M. McSherry F G H
A Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 4/207 Bouverie Street, Carlton, Vic. 3010, Australia. Email: email@example.com
B Mind Australia, 86–92 Mount Street, Heidelberg, Vic. 3084, Australia.
C Centre for Psychiatric Nursing, School of Health Sciences, The University of Melbourne, Level 6 Alan Gilbert Building, 161 Barry Street, Carlton, Vic. 3053, Australia. Email: firstname.lastname@example.org
D Department of Nursing, School of Health Sciences, The University of Melbourne, Level 6 Alan Gilbert Building, 161 Barry Street, Carlton, Vic. 3053, Australia. Email: email@example.com
E St. Vincent’s Mental Health, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia.
F Melbourne Social Equity Institute, The University of Melbourne, 201 Grattan Street, Carlton, Vic. 3053, Australia.
G Melbourne Law School, University Square, 185 Pelham Street, Carlton, Vic. 3035, Australia. Email: firstname.lastname@example.org
H Faculty of Law, Monash University, Wellington Road, Clayton, Vic. 3800, Australia.
I Corresponding author. Email: email@example.com
Australian Health Review 40(6) 599-604 https://doi.org/10.1071/AH15128
Submitted: 5 July 2015 Accepted: 9 January 2016 Published: 3 March 2016
Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings.
Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.
Results All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes.
Conclusions Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices.
What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies.
What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and family involvement, areas that have not been analysed in depth in any of the seclusion and restraint literature.
What are the implications for practitioners? This paper will give healthcare services a deeper insight into how to reduce or eliminate restraint or seclusion from the perspective of those with lived experience.
Additional keywords: consumer voice, lived experience, qualitative research, service user perspective.
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