Evaluation of seclusion and restraint reduction programs in mental health: A systematic review.

Context The effectiveness of seclusion and restraint (SR) reduction programs has not been well established. Objective To examine the effectiveness of SR reduction programs in mental health settings. Data sources A systematic review of English and French articles, using CINALH, Web of Science, PubMed, Medline, Embase, and the Cochrane Library. Additional studies were added by searching the references of identified papers. Study selection All evaluative studies on SR reduction programs in mental health were included based on predefined criteria ( n = 23 articles). Data extraction Data extraction of articles was performed using predefined data fields. The three authors conducted quality assessments independently. Data synthesis In the 23 articles analyzed, six key components were predominant in SR reduction programs: 1) leadership, 2) training, 3) post-seclusion and/or restraint review, 4) patient involvement, 5) prevention tools, and 6) the therapeutic environment. Conclusion Despite wide variability in SR indicators and methodological rigor, it remains that the outcomes argue in favor of SR reduction program implementation. [ABSTRACT FROM AUTHOR]