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Sensory assessment and therapy to help reduce seclusion use with service users needing psychiatric intensive care

Published online by Cambridge University Press:  10 March 2010

Stuart J Lee ,
Allison Cox ,
Fiona Whitecross ,
Pamela Williams  and
Yitzchak Hollander
Stuart J Lee
Affiliation:
Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychiatry and Psychology, Melbourne, Australia
Allison Cox*
Affiliation:
Department of Psychiatry, The Alfred, Melbourne, Australia Occupational Therapy Department, The Alfred, Melbourne, Australia
Fiona Whitecross
Affiliation:
Department of Psychiatry, The Alfred, Melbourne, Australia
Pamela Williams
Affiliation:
Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, School of Psychiatry and Psychology, Melbourne, Australia
Yitzchak Hollander
Affiliation:
Department of Psychiatry, The Alfred, Melbourne, Australia
*
Correspondence to: Allison Cox, The Alfred Hospital, Commercial Rd, Melbourne 3004, Australia. Tel: +61 3 9076 3526; Fax: +61 3 9076 2920; E-mail: a.cox@alfred.org.au
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Abstract

Background: In acute psychiatry, seclusion has traditionally been used to manage people at risk of harming themselves or others. However, being secluded can be traumatising and cause harm to service users and staff. In North America, sensory modulation strategies and a focus on early identification of aggression warning signs and tailored responses have significantly improved care and reduced seclusion use.

Methods: A six-month pilot of the use of sensory modulation strategies and a brief sensory and risk assessment tool (Safety Tool) was implemented on a 30-bed acute psychiatric unit. Indicators of the impact on seclusion use were audited from service users’ files with feedback collected from clinical staff.

Results: Safety Tools for 43 psychiatric intensive care service users were audited. They required significantly longer hospitalisation (mean=39.4 days) than was the average for the unit (mean=19.0 days). Whereas 65% had been previously secluded, only 26% were secluded after completing a Safety Tool. Most staff had completed or read a Safety Tool with 76% saying it should become part of standard care.

Conclusion: Findings support the significant role that sensory assessment and engagement can play in improving service user care in acute psychiatry.

Keywords

Acute psychiatryseclusion reductionsensory assessmentservice user engagement
Type
Original Article
Information
Journal of Psychiatric Intensive Care , Volume 6 , Issue 2 , December 2010 , pp. 83 - 90
Copyright
Copyright © NAPICU 2010

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