Seclusion reduction and sensory modulation

Te Pou works together with mental health and addiction services to improve the experience and outcomes for people who experience mental health and addiction problems. Seclusion: A time for change project has largely focused on supporting district health boards to safely and effectively implement sensory modulation, and to look for robust evidence and evaluation of this approach.

Te Pou is also working on a number of other projects that are designed to support the mental health and addiction workforce to enhance and grow good practice. The research evidence suggests that many of these will support the reduction of seclusion and restraint use, and also promote good practice, effective outcomes and building recovery and resilience.

Seclusion reduction (including sensory modulation)

This project is dedicated to reducing the practice of secluding or restraining patients in acute mental health inpatient wards. This work supports the Ministry of Health’s call for limiting the use of seclusion and restraint.

Sensory modulation is one of a range of clinical strategies that need to be in place to reduce seclusion and restraint use. Sensory modulation is relatively new in New Zealand mental health services but is becoming well embedded in some services.

This approach emerged from occupational therapist Tina Champagne in the USA where it has been used since the early 1970s to help children with attention and performance issues to regulate their own emotions and promote social engagement.

In mental health, people who may have previously been secluded or restrained are now being supported by mental health professionals to add to their recovery and resilience toolkits by learning how to manage their own emotional responses in positive ways.

Sensory modulation involves supporting and guiding people (often in a designated sensory room) to become calm or shift an emotional state by using sensory tools such as sights, sounds, smells, movement or modalities such as weighted blankets or massage chairs.

Te Pou is working with mental health and addiction clinicians to develop their skills and experience in this area. A range of resources has been developed to help services move to greater use of sensory modulation.

Te Pou has also been involved in evaluating the effectiveness of sensory modulation. The Sensory modulation in acute mental health wards report suggests sensory modulation is a very useful, easy to learn set of skills that is well regarded by service users, and supports clinicians to use best practices.

Opening Doors - a film about seclusion reduction

Opening Doors is a New Zealand training resource developed by Awareness: Canterbury Action on Mental Health and Addictions with support from individuals and organisations including Te Pou. It aims to help people working in the mental health sector understand the impact of seclusion on all those involved.

The training resource was released online on 30 November 2012, and free copies have been gifted to each DHB for staff training.

You can view the 23-minute film, as well as the discussion points developed to accompany it.

Australian Seclusion and Restraint Reduction Initiative

An annual forum exploring initiatives in seclusion reduction is held in Australia. The last forum was held in Adelaide in October 2011. Te Pou made a presentation on sensory modulation initiatives in New Zealand, and Australian speakers discussed seclusion reduction practices in Australia.

A webcast of the event can be viewed here (note you will need to register to view): 7th National Forum Seclusion and Restraint Project. 

Other acute work

Te Pou is developing a number of initiatives that support improved clinical practice and service user outcomes in acute inpatient mental health and addiction services. Supporting leadership in acute mental health and addiction services is a key focus. Following on from the National Acute Forum held in July 2012, regional acutes forums are currently being planned for late 2012 and early 2013. We anticipate that these will help build and nurture an environment that values excellence in practice in the specialty area of acute mental health and addiction inpatient services

A literature review has been developed around how the physical environment of services influences service users and their recovery and outcomes, clinical practices and staff.

Future work includes working alongside five DHB mental health and addiction services using the Six Core Strategies © to underpin improvement work in inpatient units.

For more information subscribe to the Te Pou e-bulletin or contact project leads.

You may also be interested in...

• Six Core Strategies for Reducing Seclusion and Restraint Use© (NASMHPD, 2008)