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TE POU LIMITED TRADING AS TE POU
Strategies to
reduce the use of
seclusion and
restraint with
tāngata whai i te
ora September 2013
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2 Strategies to reduce the use of seclusion and restraint
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3 Strategies to reduce the use of seclusion and restraint
Acknowledgments
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4 Strategies to reduce the use of seclusion and restraint
Contents
Acknowledgments ................................................................................................. 3
Executive summary ............................................................................................... 5
Introduction ........................................................................................................ 7
Literature review ................................................................................................. 8 Māori mental health statistics ......................................................................................................... 8 Seclusion and restraint ................................................................................................................ 10 Tāngata whai i te ora experiences of seclusion and restraint ................................................................... 11 Factors associated with seclusion and restraint ................................................................................... 11 Guidelines to reduce seclusion and restraint ....................................................................................... 12 Recovery-orientated services ......................................................................................................... 16 Cultural assessment and cultural competency ..................................................................................... 17 Summary ................................................................................................................................. 18
Methodology ..................................................................................................... 19
Findings ........................................................................................................... 21 Te ao Māori: access to a Māori worldview .............................................................................. 21 Te ao hurihuri (whakaumutia): transforming practice ................................................................ 26 Rangatiratanga: leadership, power, and control....................................................................... 32 Summary ...................................................................................................................... 33
Discussion ........................................................................................................ 35 Limitations .................................................................................................................... 37
Conclusion ........................................................................................................ 38
Glossary ........................................................................................................... 39
References ....................................................................................................... 41
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5 Strategies to reduce the use of seclusion and restraint
Executive summary
Recommendations for clinicians in inpatient mental health services
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6 Strategies to reduce the use of seclusion and restraint
Recommendations for leaders and managers of inpatient mental health services
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7 Strategies to reduce the use of seclusion and restraint
Introduction
Project aims
Objectives
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8 Strategies to reduce the use of seclusion and restraint
Literature review
Māori mental health statistics
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9 Strategies to reduce the use of seclusion and restraint
Admissions:
Readmissions:
Length of stay:
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10 Strategies to reduce the use of seclusion and restraint
Diagnosis:
Involuntary admissions:
Seclusion and restraint
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11 Strategies to reduce the use of seclusion and restraint
Tāngata whai i te ora experiences of seclusion and restraint
Factors associated with seclusion and restraint
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12 Strategies to reduce the use of seclusion and restraint
Guidelines to reduce seclusion and restraint
Leadership towards organisational change:
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13 Strategies to reduce the use of seclusion and restraint
The use of data to inform practice:
Workforce development:
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14 Strategies to reduce the use of seclusion and restraint
Use of seclusion and restraint prevention tools:
Practical prevention methods:
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15 Strategies to reduce the use of seclusion and restraint
Sensory modulation:
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16 Strategies to reduce the use of seclusion and restraint
Service user roles in inpatient services
Debriefing:
Recovery-orientated services
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17 Strategies to reduce the use of seclusion and restraint
Cultural assessment and cultural competency
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18 Strategies to reduce the use of seclusion and restraint
Summary
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19 Strategies to reduce the use of seclusion and restraint
Methodology
Research design
Participants
Procedure
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20 Strategies to reduce the use of seclusion and restraint
Data collection
Data analysis
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21 Strategies to reduce the use of seclusion and restraint
Findings
Te ao Māori: access to a Māori worldview
Ensuring a Māori presence and the availability of Māori healing environments at services
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22 Strategies to reduce the use of seclusion and restraint
Sustaining existing helpful Māori cultural practices and processes during the inpatient stay
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25 Strategies to reduce the use of seclusion and restraint
Providing whānau-centred care
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26 Strategies to reduce the use of seclusion and restraint
Te ao hurihuri (whakaumutia): transforming practice
Acknowledging past trauma and history
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27 Strategies to reduce the use of seclusion and restraint
Creating and sustaining changes in practice
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28 Strategies to reduce the use of seclusion and restraint
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29 Strategies to reduce the use of seclusion and restraint
Addressing challenges to implementing change
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32 Strategies to reduce the use of seclusion and restraint
Rangatiratanga: leadership, power, and control
Participation of Māori at all levels
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33 Strategies to reduce the use of seclusion and restraint
Leadership commitment to transforming practice
Summary
Leadership towards organisational change:
The use of data to inform practice:
Workforce development:
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34 Strategies to reduce the use of seclusion and restraint
Use of seclusion and restraint prevention tools:
Practical interventions:
Sensory modulation:
Service user roles in inpatient services:
Debriefing:
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35 Strategies to reduce the use of seclusion and restraint
Discussion
Implications for clinicians in inpatient mental health services
Recommendations for clinicians in inpatient mental health services
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36 Strategies to reduce the use of seclusion and restraint
Implications for sector leaders and managers of inpatient mental health services
Recommendations for sector leaders and managers of inpatient mental health services
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37 Strategies to reduce the use of seclusion and restraint
Limitations
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38 Strategies to reduce the use of seclusion and restraint
Conclusion
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39 Strategies to reduce the use of seclusion and restraint
Glossary
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41 Strategies to reduce the use of seclusion and restraint
References
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45 Strategies to reduce the use of seclusion and restraint
ā
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