Originally developed in in the United States by the National Association of State Mental Health Program Directors Medical Directors Council (NASMHPD), the Six Core Strategies © are evidence based approaches, effective in reducing seclusion and restraint events.
The New Zealand Six Core Strategies checklist was developed by Te Pou to help services in New Zealand implement the original strategies, and has been tailored for the New Zealand context.
- Leadership towards organisational change – Senior leadership must be aligned and committed to supporting, applying and resourcing seclusion and restraint reduction initiatives.
- Using data to inform practice – The use and analysis of data allows identification of service baselines to inform and improve practice.
- Workforce development – Staff training and education to create a least restrictive practice environment. This includes safe and least restrictive seclusion and restraint training, and the inclusion of technical and attitudinal competencies in job descriptions and performance evaluations.
- Use of seclusion and restraint reduction tools – The use of tools and assessments that are integrated into each service user’s treatment stay and planning e.g. assessment tools, seclusion and restraint history, safety plans, advance directives.
- Service user/consumer roles in inpatient units – Full and formal inclusion of service users or people with personal experience in recovery in a variety of roles in the service to assist in the reduction of seclusion and restraint.
- Debriefing techniques – Debriefing for both service users and staff members can assist in supporting people who have been involved in any adverse event, and reduce the traumatic impact of such events. It can also provide important information to assist both individuals and teams in planning for how they may prevent or respond to future concerns. Tertiary prevention involves learning from and adjusting both individual plans and service responses, after an adverse event.