Prolonged use of seclusion and mechanical restraint in mental health services: A statewide retrospective cohort study

Journal article


McKenna, Brian, McEvedy, Samantha, Maguire, Tessa, Ryan, Jo and Furness, Trentham. (2017). Prolonged use of seclusion and mechanical restraint in mental health services: A statewide retrospective cohort study. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.12383
AuthorsMcKenna, Brian, McEvedy, Samantha, Maguire, Tessa, Ryan, Jo and Furness, Trentham
Abstract

Seclusion and mechanical restraint are restrictive interventions that should be used only as a last resort and for the shortest possible time, yet little is known about duration of use in the broader context. Adult area mental health services throughout Victoria, Australia, were asked to complete a report form for prolonged episodes of seclusion ( > 8 hours) and mechanical restraint ( > 1 hour). The present, retrospective cohort study aimed to understand the individual (age, sex, type of service, duration of intervention) and contextual factors associated with prolonged use of restrictive interventions. Contextual factors describing the reasons for prolonged use of the restrictive interventions were captured qualitatively, and then coded using content analysis. Median duration was compared across individual factors using Mann–Whitney U‐tests. During 2014, 690 episodes of prolonged restrictive intervention involving 311 consumers were reported. Close to half (n = 320, 46%) involved mechanical restraint. Seclusion episodes (n = 370) were longer in forensic mental health services compared to adult area mental health services (median: 24 hours and 18 min vs 16 hours and 42 min, P < 0.001). Mechanical restraint episodes (n = 320) were shorter in forensic mental health services compared to adult area mental health services (median: 3 hours and 25 min vs 4 hours and 15 min, P = 0.008). Some consumers were subject to multiple episodes of prolonged seclusion (55/206, 27%) and/or prolonged mechanical restraint (31/131, 24%). The most commonly occurring contextual factor for prolonged restrictive interventions was ‘risk of harm to others’. Means for reducing the use of prolonged restrictive interventions are discussed in light of the findings.

Year2017
JournalInternational Journal of Mental Health Nursing
PublisherWiley Online Library
ISSN1447-0349
Digital Object Identifier (DOI)https://doi.org/10.1111/inm.12383
Page range491 - 499
Research GroupSchool of Nursing, Midwifery and Paramedicine
Publisher's version
File Access Level
Controlled
EditorsK. Usher
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Prebble, Kate, Diesfeld, Kate, Frey, Rosemary Ann, Sutton, Daniel, Honey, Michelle, Vickery, Russell and McKenna, Brian. (2013). The care manager's dilemma : Balancing human rights with risk management under the intellectual Disability (Compulsory Care and Rehabilitation) Act 2003. Disability and Society. https://doi.org/10.1080/09687599.2012.695527
Reporting of suicide by the New Zealand media
Thom, Katey, McKenna, Brian, Edwards, Gareth, O'Brien, Anthony and Nakarada-Kord, Ivana. (2012). Reporting of suicide by the New Zealand media. Crisis. 33(4), pp. 199 - 207. https://doi.org/10.1027/0227-5910/a000133
Patterns of mental health service contact before and after forensic mental health contact in New Zealand
Cavney, James, Skipworth, Jeremy, Madell, Dominic and McKenna, Brian. (2012). Patterns of mental health service contact before and after forensic mental health contact in New Zealand. Australasian Psychiatry. 20(3), pp. 225 - 227. https://doi.org/10.1177/1039856212437258
Efficacy of a whole-body vibration intervention to effect exercise tolerance and functional performance of the lower limbs of people with chronic obstructive pulmonary disease
Furness, Trentham, Bate, Nicole, Welsh, Liam, Naughton, Geraldine and Lorenzen, Christian. (2012). Efficacy of a whole-body vibration intervention to effect exercise tolerance and functional performance of the lower limbs of people with chronic obstructive pulmonary disease. BMC Pulmonary Medicine. 12(71), pp. 1 - 6. https://doi.org/10.1186/1471-2466-12-71
Effect of performance jewlery on balance of elite Australian rules footballers and healthy young adults
Joseph, Corey, Furness, Trentham, Buttifant, David and Naughton, Geraldine. (2012). Effect of performance jewlery on balance of elite Australian rules footballers and healthy young adults. In E J Bradshaw, A Burnett and P A Hume (Ed.). 30th Conference of the International Society of Biomechanics in Sports. Australia: International Society of Biomechanics. pp. 162 - 165
Community Engagement through the Arts: An interdisciplinary approach developed in an Australian University
Farrell, Lindsay, Ryan, Delyse, Sanders, Tracey and Fromyhr, Judith. (2012). Community Engagement through the Arts: An interdisciplinary approach developed in an Australian University. International Journal of the Arts in Society. 7(1), pp. 9 - 20.
Improving the ability of mental health nurses to give second opinion in judicial reviews :An evaluation study
McKenna, Brian, O'Brien, Anthony and O'Shea, Maria. (2011). Improving the ability of mental health nurses to give second opinion in judicial reviews :An evaluation study. Journal of Psychiatric and Mental Health Nursing. 18(6), pp. 550 - 557. https://doi.org/10.1111/j.1365-2850.2011.01703.x
Magic beach
Ryan, Delyse. (2011). Magic beach
Wombat stew
Ryan, Delyse. (2011). Wombat stew
Implementing and maintaining nurse-led healthy living programs in forensic inpatient settings :An illustrative case study
Prebble, Kate, Kidd, Jacquie Dianne, O'Brien, Anthony, Carlyle, Dave, McKenna, Brian, Crowe, Marie, Deering, Daryle and Gooder, Claire. (2011). Implementing and maintaining nurse-led healthy living programs in forensic inpatient settings :An illustrative case study. Journal of American Psychiatric Nurses Association. 17(2), pp. 127 - 138. https://doi.org/10.1177/1078390311399094
Where's spot?
Ryan, Delyse. (2011). Where's spot
Suicide online :portrayal of website-related suicide by the New Zealand media
Thom, Katey, Edwards, Gareth, Nakarada-Kordic, Ivana, McKenna, Brian, O'Brien, Anthony and Nairn, Raymond. (2011). Suicide online :portrayal of website-related suicide by the New Zealand media. New Media and Society. 13(8), pp. 1355 - 1372. https://doi.org/10.1177/1461444811406521
We're going on a bear hunt
Ryan, Delyse. (2011). We're going on a bear hunt
Toil and trouble: Using Shakespeare as a prompt for physical theatre
Ryan, Delyse and Heffernan, Catherine. (2011). Toil and trouble: Using Shakespeare as a prompt for physical theatre. Journal of Queensland Drama Educators. 34(1), pp. 4 - 9.
The midnight gang
Ryan, Delyse. (2011). The midnight gang
Use of Tasers on people with mental illness. A New Zealand database study
O'Brien, Anthony, McKenna, Brian, Thom, Katey, Diesfeld, Kate and Simpson, Alexander. (2011). Use of Tasers on people with mental illness. A New Zealand database study. International Journal of Law and Psychiatry. 34(1), pp. 39 - 43. https://doi.org/10.1016/j.ijlp.2010.11.006
Insanity, methamphetamine and psychiatric expertise in New Zealand courtrooms
Thom, Katey, Finlayson, Mary and Mckenna, Brian. (2011). Insanity, methamphetamine and psychiatric expertise in New Zealand courtrooms. Journal of Law and Medicine. 18(4), pp. 749 - 758.
This way up
Ryan, Delyse and Heffernan, Catherine. (2011). This way up
Mental health and addiction services in the criminal justice system: Where do we sit?
McKenna, Brian. (2011). Mental health and addiction services in the criminal justice system: Where do we sit? International Journal of Mental Health Nursing. 20(2), pp. 75 - 76. https://doi.org/10.1111/j.1447-0349.2010.00738.x
Introducing university students to the possibilities of performing in the community: A case study of early childhood dramatic performance
Ryan, Delyse. (2011). Introducing university students to the possibilities of performing in the community: A case study of early childhood dramatic performance. The International Journal of the Arts in Society (print version). 6(2), pp. 91 - 98.
Possum Magic
Ryan, Delyse. (2011). Possum Magic
Who sank the boat?
Ryan, Delyse. (2011). Who sank the boat
Puttin' on the ritz
Ryan, Delyse. (2011). Puttin' on the ritz
Where the wild things are
Ryan, Delyse. (2011). Where the wild things are
In search of a national approach to professional supervision for mental health and addiction nurses : The New Zealand experience
McKenna, Brian, Thom, Katey, Howard, Fiona and Williams, Val. (2010). In search of a national approach to professional supervision for mental health and addiction nurses : The New Zealand experience. Contemporary Nurse: Health care across the lifespan. 34(2), pp. 267 - 276. https://doi.org/10.5172/conu.2010.34.2.267
Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults
Furness, Trentham, Maschette, Wayne, Lorenzen, Christian, Naughton, Geraldine and Williams, Morgan. (2010). Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults. Journal of Alternative & Complementary Medicine. 16(7), pp. 795 - 797. https://doi.org/10.1089/acm.2009.0366
Duly authorized officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?: Feature article
McKenna, Brian, Thom, Katey, O'Brien, Anthony John, Crene, Sally and Simpson, A.. (2009). Duly authorized officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?: Feature article. International Journal of Mental Health Nursing. 18(4), pp. 231 - 238. https://doi.org/10.1111/j.1447-0349.2009.00619.x
Community treatment orders and competence to consent
Milne, Duncan, O'Brien, Anthony John and McKenna, Brian. (2009). Community treatment orders and competence to consent. Australasian Psychiatry. 17(4), pp. 273 - 278. https://doi.org/10.1080/10398560902721572
Compulsory community mental health treatment: Literature review
O'Brien, Anthony John, McKenna, Brian and Kydd, Robert R.. (2009). Compulsory community mental health treatment: Literature review. International Journal of Nursing Studies. 46(9), pp. 1245 - 1255. https://doi.org/10.1016/j.ijnurstu.2009.02.006
Judging nursing practice: Implications of habeas corpus rulings for mental health nurses in New Zealand
Thom, Katey, O'Brien, Anthony John and McKenna, Brian. (2008). Judging nursing practice: Implications of habeas corpus rulings for mental health nurses in New Zealand. Psychiatry, Psychology and Law. 15(1), pp. 131 - 139. https://doi.org/10.1080/13218710701879558
Return to nursing programmes: Justifications for a mental health specific course
McKenna, Brian, Thom, Katey and O'Brien, Anthony John. (2008). Return to nursing programmes: Justifications for a mental health specific course. International Journal of Nursing Education Scholarship. 5(1), pp. 1 - 16. https://doi.org/10.2202/1548-923X.1618
The unintended impact of the therapeutic intentions of the New Zealand Mental Health Review Tribunal? Therapeutic jurisprudence perspectives
Diesfeld, Kate and McKenna, Brian. (2007). The unintended impact of the therapeutic intentions of the New Zealand Mental Health Review Tribunal? Therapeutic jurisprudence perspectives. Journal of Law and Medicine. 14(4), pp. 566 - 574.
Concerns about the use of TASERs on people with mental illness in New Zealand
O'Brien, Anthony John and McKenna, Brian. (2007). Concerns about the use of TASERs on people with mental illness in New Zealand. Journal of Forensic Nursing. 3(2), pp. 89 - 92. https://doi.org/10.1097/01263942-200706000-00008
Outcome of patients rehabilitated through a New Zealand Forensic Psychiatry Service: A 7.5 year retrospective study
Simpson, Sandy, Simpson, A., Jones, Roland Morgan, Evans, Ceri G. and McKenna, Brian. (2006). Outcome of patients rehabilitated through a New Zealand Forensic Psychiatry Service: A 7.5 year retrospective study. Behavioral Sciences and the Law. 24(6), pp. 833 - 843. https://doi.org/10.1002/bsl.740
Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: A national study
Simpson, A., Skipworth, Jeremy J., McKenna, Brian, Moskowitz, Andrew K. and Barry-Walsh, Justin B.. (2006). Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: A national study. Australian and New Zealand Journal of Psychiatry. 40(9), pp. 804 - 809. https://doi.org/10.1111/j.1440-1614.2006.01887.x
Be-medalled and be-ribboned: Soldiers and civilians on Brisbane's streets in World War II
Ryan, Delyse. (2006). Be-medalled and be-ribboned: Soldiers and civilians on Brisbane's streets in World War II. Journal of Australian Studies. 89, pp. 41 - 51.
The therapeutic intent of the New Zealand Mental Health Review Tribunal
Diesfeld, Kate and McKenna, Brian. (2006). The therapeutic intent of the New Zealand Mental Health Review Tribunal. Psychiatry, Psychology and Law. 13(1), pp. 100 - 109. https://doi.org/10.1375/pplt.13.1.100
Best practice management strategies for mental health nurses during the clinical application of civil commitment: an overview
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2006). Best practice management strategies for mental health nurses during the clinical application of civil commitment: an overview. Contemporary Nurse. 21(1), pp. 62 - 70. https://doi.org/10.5172/conu.2006.21.1.62
Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992
McKenna, Brian, O'Brien, Anthony John, Dal Din, Toni and Thom, Kate. (2006). Registered nurses as responsible clinicians under the New Zealand Mental Health (Compulsory Assessment and Treatment) Act 1992. International Journal of Mental Health Nursing. 15(2), pp. 128 - 134. https://doi.org/10.1111/j.1447-0349.2006.00412.x
The role of mental illness in homicide-suicide in New Zealand, 1991 - 2000
Moskowitz, Andrew K., Simpson, A., McKenna, Brian, Skipworth, Jeremy J. and Barry-Walsh, Justin B.. (2006). The role of mental illness in homicide-suicide in New Zealand, 1991 - 2000. Journal of Forensic Psychiatry and Psychology. 17(3), pp. 417 - 430. https://doi.org/10.1080/14789940600761410
Outpatient commitment and coercion in New Zealand: A matched comparison study
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2006). Outpatient commitment and coercion in New Zealand: A matched comparison study. International Journal of Law and Psychiatry. 29(2), pp. 145 - 158. https://doi.org/10.1016/j.ijlp.2004.07.004
Gambling and problem gambling among recently sentenced women in New Zealand prisons
Abbott, Max W. and McKenna, Brian. (2005). Gambling and problem gambling among recently sentenced women in New Zealand prisons. Journal of Gambling Studies. 21(4), pp. 559 - 581. https://doi.org/10.1007/s10899-005-5563-5
Gambling and problem gambling among recently sentenced male prisoners in four New Zealand prisons
Abbott, Max W., McKenna, Brian and Giles, Lynne C.. (2005). Gambling and problem gambling among recently sentenced male prisoners in four New Zealand prisons. Journal of Gambling Studies. 21(4), pp. 537 - 558. https://doi.org/10.1007/s10899-005-5562-6
New nurses face endemic violence
McKenna, Brian, Poole, Suzette J., Smith, Naumai A. and Cloverdale, John H.. (2004). New nurses face endemic violence. Kai Tiaki: Nursing New Zealand. 10(5), pp. 12 - 14.
Homicide and mental illness in New Zealand, 1970-2000
Simpson, A., McKenna, Brian, Moskowitz, Andrew K., Skipworth, Jeremy J., Barry-Walsh, Justin B. and Simpson, Sandy. (2004). Homicide and mental illness in New Zealand, 1970-2000. British Journal of Psychiatry. 185(NOV), pp. 394 - 398. https://doi.org/10.1192/bjp.185.5.394
Patients' perceptions of coercion on admission to forensic psychiatric hospital: A comparison study
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2003). Patients' perceptions of coercion on admission to forensic psychiatric hospital: A comparison study. International Journal of Law and Psychiatry. 26(4), pp. 355 - 372. https://doi.org/10.1016/S0160-2527(03)00046-3
'Does all Melbourne smell like this?': The colonial metropolis in marvellous Melbourne
Ryan, Delyse. (2003). 'Does all Melbourne smell like this?': The colonial metropolis in marvellous Melbourne. Australian Literary Studies. 21(1), pp. 81 - 91.
Horizontal violence: Experiences of Registered Nurses in their first year of practice
McKenna, Brian, Smith, Naumai A., Poole, Suzette J. and Cloverdale, John H.. (2003). Horizontal violence: Experiences of Registered Nurses in their first year of practice. Journal of Advanced Nursing. 42(1), pp. 90 - 96. https://doi.org/10.1046/j.1365-2648.2003.02583.x
Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation
Farrow, Tony L., McKenna, Brian and O'Brien, Anthony John. (2002). Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation. International Journal of Mental Health Nursing. 11(3), pp. 164 - 169.
'Two hours genuine fun without the vulgarity': As the bishop said to the actress
Ryan, Delyse. (2002). 'Two hours genuine fun without the vulgarity': As the bishop said to the actress. The Journal of Religion and Theatre. 1(1), pp. 1 - 13.
Initiating committal proceedings 'just in case' with voluntary patients: a critique of nursing practice
Farrow, Tony L., McKenna, Brian and O'Brien, Anthony John. (2002). Initiating committal proceedings 'just in case' with voluntary patients: a critique of nursing practice. Nursing Praxis in New Zealand. 18(2), pp. 15 - 23.
Risk assessment of violence to others: time for action
McKenna, Brian. (2002). Risk assessment of violence to others: time for action. Nursing Praxis in New Zealand. 18(1), pp. 36 - 43.
An analysis of procedural justice during psychiatric hospital admission
McKenna, Brian, Simpson, A., Cloverdale, John H. and Laidlaw, Tannis M.. (2001). An analysis of procedural justice during psychiatric hospital admission. International Journal of Law and Psychiatry. 24(6), pp. 573 - 581. https://doi.org/10.1016/S0160-2527(00)00069-8
Debating forensic mental health nursing
McKenna, Brian and Poole, Suzette J.. (2001). Debating forensic mental health nursing. Kai Tiaki: Nursing New Zealand. 7(6), pp. 18 - 20.
What is the role of procedural justice in civil commitment?
McKenna, Brian, Simpson, A. and Cloverdale, John H.. (2000). What is the role of procedural justice in civil commitment? Australian and New Zealand Journal of Psychiatry. 34(4), pp. 671 - 676. https://doi.org/10.1046/j.1440-1614.2000.00744.x
Implications for training of violent acts by patients against psychiatry registrars
Gale, Christopher K., Simpson, A., McKenna, Brian and Cloverdale, John H.. (2000). Implications for training of violent acts by patients against psychiatry registrars. Australasian Psychiatry. 8(4), pp. 345 - 348. https://doi.org/10.1046/j.1440-1665.2000.00289.x
Patient perception of coercion on admission to acute psychiatric services: The New Zealand experience
McKenna, Brian, Simpson, A. and Laidlaw, Tannis M.. (1999). Patient perception of coercion on admission to acute psychiatric services: The New Zealand experience. International Journal of Law and Psychiatry. 22(2), pp. 143 - 153. https://doi.org/10.1016/S0160-2527(98)00039-9
To tell or not to tell?
McKenna, Brian. (1997). To tell or not to tell? Kai Tiaki: Nursing New Zealand. 3(4), pp. 28 - 29.