Seclusion reduction and sensory modulation
Te Pou is working together with mental health and addiction services to improve the experience of service users. This is an on-going project that includes the Seclusion: A time for change project that has largely focussed on supporting district health boards to safely implement sensory modulation, and to provide robust evidence and evaluation of this intervention.
Te Pou is also working on a number of other projects that are designed to support clinicians to deliver good practice. The research evidence suggests that many of these will also help reduce seclusion and restraint use, but also promote good practice generally.
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 care. 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 arousal and promote social engagement.
In mental health, some people who would previously have been secluded or restrained are now, with support from mental health professionals, learning to regulate their own responses and de-escalate emotions.
Sensory modulation involves assisting a service user, often in a designated sensory room, to become calm by using sensory tools such as music or a weighted blanket.
Te Pou is working with mental health 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 is also involved in evaluating the effectiveness of sensory modulation. Initial data 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 other best practices.
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 clinical practice in acute inpatient mental health and addiction services. The work in this area includes the production of a literature review of the best evidence for effective training for clinicians in de-escalation techniques. There is evidence that some types of training will help reduce seclusion and restraint usage, while promoting a better environment for clinicians and service users.
Supporting leadership in acute mental health and addiction services is another focus for us that will support front line clinicians to meet, discuss, network, have time to reflect on best practice and the chance to look at latest literature that supports improving services. We anticipate that this will help build and nurture an environment that values excellence in practice in the specialty area of acute mental health and addiction inpatient services.
We plan to be able to support the sector with various publications. These include an update on the best evidence for practices that can help to reduce seclusion use, a literature review on the evidence of effectiveness of the use of peer workers in acutes, and a literature review showing how the physical environment can influence practice in acute units.
