Eliminating seclusion and restraint in recovery-oriented crisis services.

The use of seclusion and physical restraint is viewed as a practice incompatible with the vision of recovery, and its therapeutic benefit remains unsubstantiated. This Open Forum describes an initiative that began in 1999 at two crisis centers that was designed to completely eliminate the practice of seclusion and restraint. Seclusion and restraint elimination strategies included strong leadership direction, policy and procedural change, staff training, consumer debriefing, and regular feedback on progress. Existing records indicated that over a 58-month follow-up period (January 2000 to October 2004), the larger crisis center took ten months until a month registered zero seclusions and 31 months until a month recorded zero restraints. The smaller crisis center achieved these same goals in two months and 15 months, respectively. The success of this initiative suggests that policy makers and organizational leaders familiarize themselves with these and other similar seclusion and restraint reduction strategies that now exist.