Elements of successful restraint and seclusion reduction programs and their application in a large, urban, state psychiatric hospital.

In recent years, there has been a strong desire on the part of inpatient psychiatric programs to reduce the use of seclusion and mechanical restraint. There is a consensus among those who have published descriptions of successfully implemented restraint and seclusion reduction programs that the essential elements of such programs are high level administrative endorsement, participation by recipients of mental health services, culture change, training, data analysis, and individualized treatment. This article describes these elements and their application in a successful restraint reduction program at Creedmoor Psychiatric Center, a large, urban, state-operated psychiatric hospital that reduced its combined restraint and seclusion rate by 67% over a period of 2 years.