Restrictive Practices in Secure Mental Health Services

  • Research type

    Research Study

  • Full title

    Restrictive Practices in Restrictive Places: Factors associated with, and interventions to reduce, restrictive practices in secure mental health settings.

  • IRAS ID

    299649

  • Contact name

    Daniel Lawrence

  • Contact email

    daniellawrence@priorygroup.com

  • Sponsor organisation

    Priory Group

  • Clinicaltrials.gov Identifier

    N/A, N/A

  • Duration of Study in the UK

    5 years, 0 months, 1 days

  • Research summary

    The aim of the study is to identify service level factors and patient characteristics associated with restrictive practice (RP) use in secure mental health services and to design and evaluate a series of brief, staff focussed interventions involving training, consultation and routine practice changes aimed at reducing the use of RPs in a secure mental health service that consists of six wards. The research site will be Llanarth Court Hospital, an independent sector secure mental health hospital. The project will consist of the following:

    1. Analysis of data on restrictive intervention incidents from the Central Priory UK patient database, using logistical regression to identify factors predictive of restrictive interventions.

    2. Qualitative study of doctors’, nurses’ and service users’ perspectives on the use of seclusion. Focus will be on when it is appropriate and how long it should last. Semi structured interviews will be analysed using Grounded Theory to inform the development of a process model of seclusion related decision making.

    3. A patient case study evaluating the effectiveness of a bespoke package of care for a patient with a long history of experiencing restrictive interventions aimed at reducing the frequency and duration of restrictive interventions.

    4. Analysis of the effectiveness of a short term risk assessment known as the Dynamic Appraisal of Situational Aggression (DASA) in reducing restrictive practices across 6 wards of a secure mental health hospital.

    5. An evaluation of a compassion focused staff support group for staff working on two of the wards of the secure service described above. The aim is analyses change on three outcome measures, including staff attitudes, and self efficacy in relation to avoiding restrictive practices.

  • REC name

    Wales REC 5

  • REC reference

    22/WA/0098

  • Date of REC Opinion

    26 May 2022

  • REC opinion

    Further Information Favourable Opinion