Reducing Restrictive Interventions in Inpatient Mental Healthcare Facilities: A Literature Review

Abstract

BACKGROUND: One common characteristic of mental health facilities is the violence and aggression that most patients exhibit. Such characteristics threaten the safety of the patients as well as that of the healthcare providers. Interventions have been put in place to prevent such aggression among mental patients. One of the common interventions is physical or chemical restriction. However, such interventions not only violate the dignity of the patients but also have negative repercussions on the treatment process and recidivism among the patients. Purpose: This study aimed to identify methods and models that would reduce the need for restrictive interventions to challenging behavior by mentally ill patients in inpatient psychiatric healthcare facilities.
 
 METHODS: The researcher examined databases that had information concerning mental health. These included CINAHL, PSYCINFO, EMBASE, MEDLINE, and Google Scholar. The quality appraisal used in the Cochrane Library database encompasses several systematic reviews that have been published. The data analysis that was used in this research was based on the findings of other researchers' content analysis and was an excellent technique in the research methodology. 
 
 RESULTS: The researcher employed the inclusion criteria from the previous chapter and identified 108 studies. The author applied qualitative research synthesis to analyze the literature and extract data for interpretation in the study. The majority of the studies used qualitative methodologies. The CASP tool was indispensable in appraising every study considered in the paper. Several health services have committed to the substantial reduction or elimination of the use of restrictive interventions. Restrictive practices can be reduced and often eliminated in healthcare services. The weight of evidence that seclusion and restraint can be reduced and eliminated comes from reports of these outcomes being achieved in mental health services. There is also evidence of seclusion and restraint being reduced in emergency departments and disability services. 
 
 CONCLUSION: Mental healthcare providers might argue that using restrictive interventions within the context of the medical care environment presents an excellent way of dealing with aggressive and violent people. Researchers in the future need to use actual test subjects. They need to conduct clinical trials to ensure that they can validate the results of the current study. 
 
 RECOMMENDATIONS: Intervention development should be theoretically informed and be conducted in collaboration with people who have lived experience of this issue. Limit setting may be effective for preventing and managing aggression. Observation is potentially a powerful strategy for preventing and managing aggression.