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Restraint/Seclusion Reduction Initiative (RSRI)

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In November 2000, the Massachusetts Department of Mental Health (DMH), through its Licensing and Child/Adolescent Services Divisions, embarked on a mission to reduce and ultimately eliminate the use of restraint and seclusion in all child and adolescent inpatient and intensive residential treatment facilities in the state. Between November 2000 and January 2005, episodes of restraint and seclusion (per 1,000 patient days) decreased 84.4%, 80.4% and 78.7%, respectively, in child (ages 5-12), adolescent and mixed child/adolescent units. This work is ongoing.

In the fall of 2004, Massachusetts DMH was one of eight states selected by SAMHSA to receive a State Infrastructure Grant (SIG) to develop alternatives to restraint and seclusion in DMH-operated and contracted adult inpatient facilities, which also include three adolescent inpatient units. DMH kicked off this new initiative to reduce/eliminate restraint and seclusion in DMH facilities in July 2005.

Included on this web site are some of the tools that have been used to provide technical assistance and consultation to the units/facilities and some other, associated statistics. Other information will be added from time to time.

Sample Safety Tools

•  The Safety Tool - Adult Version (PDF) l Word

• The Safety Zone Tool - Adolescent Version (PDF) l Word

• The Safety  Tool for Kids (PDF) l Word

• The Boston Medical Center Intensive Residential Treatment Program (IRTP) Safety Tool - Adolescent Version (PDF) l Word

Seclusion and Restraint Data Indicators

•  Data Indicators July 2000 - June 2007 (PDF) l Word

Related Publications

• Regulatory Change: A Pathway to Eliminating Seclusion and Restraint or "Regulatory Sotoma"? (PDF) l Word

• Child and Adolescent Inpatient Restraint Reduction:  A State Initiative to Promote Strength-Based Care (PDF) l Word

• Final Improvement Planning Document (PDF) l Word

• Rate of Injury - Staff and Patients (PDF) l RTF

• Massachusetts DMH - Staff and Resident injuries in Continuing Care Units (Chart) (Excel) l RTF

• DMH Restraint and Seclusion Philosophy Statement, Sept 2007 (PDF) l Word

• SAMHSA Grant Kick-Off (PDF) l Word

• The Economic Cost of Using Restraint and the Value Added by Restraint Reduction or Elimination (PDF) l Word

• Sensory Approaches in Inpatient Psychiatric Settings (PDF) l Word

• Resource Guide: Creating Positive Cultures of Care (PDF) l Word

 

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This information is provided by the  Department of Mental Health