Reducing Restrictive Practice
Restrictive practice is defined as ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a person’ (Section 9, National Disability Insurance Scheme Act, 2013). It has also been defined as ‘making someone do something they don’t want to do or stopping someone from doing something they want to do’ (Skills for Health, 2014).
The use of restrictive practices is most commonly associated with mental health hospital environments, but its use does occur in other settings as well. Best clinical practice informs that restrictive practice techniques should only be used as the last possible resort in response to risk of harm to a person or others and only after a provider has explored and applied evidence-based, person-centred and proactive strategies.
The focus of our clinically-informed framework has always been to provide the least restrictive package of support possible. We use the PROACT-SCIPr-UK® framework, a ‘whole approach’ to supporting individuals with complex needs or who may present with behaviour perceived to be challenging, focussing on three core aspects: the individual, staff and organisation. Physical interventions would only be used as a last resort.
What are the types of restrictive practices?
There are six types of restrictive practice. These are:
Chemical: the use of medication to address behaviours of concern. It does not include the use of medication prescribed by a medical practitioner to treat a mental health condition.
Environmental: restricting a person’s access to all parts of their environment, to items or to activities. Examples might be locking a door to prevent a person’s access or denying a person access to their mobile phone.
Mechanical: the use of a device or item to address behaviours of concern. Examples include use of helmet to prevent head butting behaviour and gloves to prevent skin picking.
Physical: the use of physical force to prevent, restrict or subdue movement. This form of restraint should only be used for serious behaviours of concern to prevent harm to self or others when other methods have failed. Physical restraint can range from holding a person’s arm down to prevent them from harming others to full prone restraint.
Seclusion: the confinement of a person in a room or physical space.
Psychological: depriving a person of choices, controlling them through not permitting them to do something, making them do something or setting limits on what they can do, without physically intervening. It includes the use of threats and coercion.
Everyone working at Gray Healthcare, irrespective of their role, receives PROACT-SCIPr-UK® delivered in person by our clinical team. Staff members working closely with the people we support receive person-centred training relating to the person they support.
The PROACT-SCIPr-UK® curriculum is certificated by Bild Association for Certificated Training (Act) against the Restraint Reduction Network Training Standards (RRN).
See how we’re successfully reducing the use of restrictive practices in our latest clinical outcomes report.