While least restrictive practice is the aim of service delivery for people who are experiencing mental health and addiction problems, there are times currently when a restraint may happen. To ensure this only happens as a last resort and with the highest degree of respect, safety and dignity for the person and staff, the Safe Practice Effective Communication (SPEC) training programme was developed.

SPEC was launched in Christchurch in late November. The launch was a credit to many people who have worked hard to get to this point with the aim of achieving a national consistency of training that is pain free and prone free wherever possible. The strong emphasis on prevention and therapeutic communication skills and strategies supports inpatient staff to reduce the incidence of restraints. Essentially however, it is about how two human beings interact with each other, and the notion of doing no harm.

SPEC is a training programme for mental health clinicians who work in inpatient units. It is delivered through a ‘train the trainer’ model. DHBs are working in regional alliances to support the development and implementation of the programme.

Kathy Moore (Counties Manukau DHB), Michelle Atkinson and Dean Rangihuna (Canterbury DHB) spoke about delivering this training and the importance and strength of the clinical and service user trainer model. This aspect of training was evident throughout the two days. Hearing Dean speak was a compelling reminder to us about why we need to do this work, and the need to “maintain the human face in the middle”. There was discussion in the two days around humanity, respect, human rights and the need to ensure service users are involved in all levels of the training.

SPEC is a new initiative in that it is a collaboration between all DHB’s, under the leadership of the National Directors of Mental Health Nursing. The initiative also involves a number of other key stakeholders including service user groups, Māori and Te Pou. These groups will be continuing to work together on the ongoing development and sustainability of the program via a SPEC governance board. The interim board had its first meeting immediately after the launch.

The ongoing focus will be maintaining national consistency and continuing to improve the program with best quality evidence based and innovative practice to reduce restrictive practices, and ongoing support for trainer development.

Te Pou is excited to be involved in this initiative as it enables much of the work in Towards restraint free practice to be realised.

Reflection time

Looking for evidence to reflect on and integrate into your practice then please read more about our initiative to reduce seclusion and restraint.