Journal ArticleDOI
Two-Year Trends in the Use of Seclusion and Restraint Among Psychiatrically Hospitalized Youths
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TLDR
National reforms and institutional efforts can lead to downward trends in the use of seclusion and restraint among psychiatrically hospitalized youths, and the active elements of these interventions warrant further study and replication.Abstract:
OBJECTIVES: This study examined characteristics associated with the use of seclusion and restraint among 442 psychiatrically hospitalized youths and sought to quantify changing trends in the rates of these modalities of treatment over time after the 1999 implementation of federal regulations and an institutional performance improvement program. METHODS: Demographic and clinical data related to all 5,929 incidents of seclusion and restraint that occurred during 2000 and 2001 at a child and adolescent state psychiatric hospital were analyzed. RESULTS: The two-year prevalence of use of seclusion was 61 percent and of restraint was 49 percent. Children and adolescents who were admitted on an emergency basis and those belonging to ethnic minority groups were more likely to undergo seclusion or restraint. Children aged 11 years and younger were more likely to undergo seclusion. The total number of episodes decreased by 26 percent and their cumulative duration decreased by 38 percent between the first quarter of...read more
Citations
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Racial and Ethnic Disparities in U.S. Health Care: A Chartbook
TL;DR: This paper presents research around disparities in chronically ill patients' self-management skills, as well as access barriers for vulnerable populations, including minorities, the uninsured, and the underserved, at GWU's School of Public Health and Health Services.
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Psychological needs and threat to safety: Implications for staff and patients in a psychiatric hospital for youth.
TL;DR: In this paper, the authors tested hypotheses derived from self-determination theory concerning the relations of workplace need satisfaction and perceived threat to motivation, attitudes, and well-being among clinical staff within an adolescent psychiatric inpatient hospital.
Journal ArticleDOI
Effectiveness of Six Core Strategies Based on Trauma Informed Care in Reducing Seclusions and Restraints at a Child and Adolescent Psychiatric Hospital
Muhammad Waqar Azeem,Akashdeep Aujla,Akashdeep Aujla,Akashdeep Aujla,Michelle Rammerth,Gary Binsfeld,Robert B. Jones +6 more
TL;DR: This study shows downward trend in seclusions/restraints among hospitalized youth after implementation of National Association of State Mental Health Program Directors six core strategies based on trauma informed care.
Journal ArticleDOI
Interventions to reduce the use of seclusion and restraint in inpatient psychiatric settings: what we know so far. A review of the literature.
TL;DR: Evidence available from evaluations of single seclusion and/or restraint reduction programmes indicates that a range of reduction programmes are successful in reducing the frequency and duration ofSeclusion and restraint use, while at the same time maintaining a safe environment.
Journal ArticleDOI
Child and adolescent inpatient restraint reduction: a state initiative to promote strength-based care
Janice LeBel,Nan Stromberg,Kenneth Duckworth,Joan P. Kerzner,Robert Goldstein,Michael Weeks,Gordon Harper,Lareina LaFlair,Marylou Sudders +8 more
TL;DR: The use of restraint and seclusion in child and adolescent inpatient settings can be reduced through a systems approach, which may have applicability to other settings and systems.
References
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TL;DR: This article discusses extensions of generalized linear models for the analysis of longitudinal data in which heterogeneity in regression parameters is explicitly modelled and uses a generalized estimating equation approach to fit both classes of models for discrete and continuous outcomes.
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The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, Acceptability, Prevalence Rates, and Performance in the MECA Study
David Shaffer,Prudence W. Fisher,Mina K. Dulcan,Mark Davies,John Piacentini,Mary Schwab-Stone,Benjamin B. Lahey,Karen H. Bourdon,Peter S. Jensen,Hector R. Bird,Glorisa Canino,Darrel A. Regier +11 more
TL;DR: The DISC-2 is a reliable and economical tool for assessing child psychopathology and the 2.3 version of the instrument provides a significant improvement over earlier versions.
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Use of inpatient mental health services by members of ethnic minority groups.
TL;DR: This article found that ethnic-related differences in socioeconomic standing and in the prevalence of major psychopathology, differential stigma, or capacity to tolerate or support a dysfunctional significant other; access and use of alternative services; and bias in the behavior of gatekeepers, especially practitioners assigning diagnostic labels and making involuntary commitment decisions.
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Ethnic minority adolescents and the use of community mental health care services.
TL;DR: Analyses showed that Asian Americans and Hispanics are underrepresented in existing public mental health facilities while African Americans are overrepresented; but, for length of treatment, Asian Americans tend to stay longer in treatment while African American tends to stay in treatment for a shorter period of time than whites.
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Practice Parameter for the Prevention and Management of Aggressive Behavior in Child and Adolescent Psychiatric Institutions, With Special Reference to Seclusion and Restraint
TL;DR: This parameter reviews the current state of the prevention and management of child and adolescent aggressive behavior in psychiatric institutions, with particular reference to the indications and use of seclusion and restraint.