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Post-Seclusion Debriefing Peer Support Program

Enhance mental health support post-seclusion with peer debriefing. Implementing consumer-centered strategies to reduce seclusion and restraint.

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Post-Seclusion Debriefing Peer Support Program

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  1. Consumer Support Program:a peer support for post-seclusion debriefing Andrew Strachan, Consumer Liaison Officer Irene Francisco, Recovery Coordinator The Park – Centre for Mental Health Mental Health & Specialised Services Wacol, Queensland

  2. The Park – Centre for Mental Health • High Security Inpatient Service (70 beds) - State-wide facility • Secure Mental Health Rehabilitation Unit (34 beds) • Extended Forensic Treatment & Rehabilitation Unit(15 beds) • Extended Treatment & Rehabilitation Unit – closing this year

  3. The lived experience….

  4. Consumer Support Program • Meeting Strategy 6 of the Six Core Strategies to Reduce the Use of Seclusion and Restraint (National Technical Assistance Center, 2005) • Lack of consistent approach to debriefing (Meehan et al, 2000; Ryan & Happell, 2009) • Previous model in 2009 used clinical staff to deliver post-seclusion debriefing, and based on Critical Incident Stress Debriefing approaches. • Debriefing tool developed by Ipswich Mental Health Unit to try consistency in staff approach to debriefing in acute unit.

  5. The notification process The notification process The notification process The notification process The notification process The consent process The consent process The consent process Follow-up and feedback Follow-up and feedback Follow-up and feedback

  6. This is how we document… • Levels of consent to share information: • Just with consumer support • With clinical team • With Seclusion & Restraint workgroup • Choices • Kept with Consumer and Carer Engagement Service

  7. The data…. • Commenced as trial in Secure Mental Health Rehabilitation Unit in 2014 • Expanded to the High Security service in 2015 • 18 responses in the first 12 months • 7 out of 18 (39%) – consumers agreed to discuss • Of the 7 consumers who agreed to discuss, only 2 wanted feedback to go to the clinical team or the seclusion & restraint workgroup

  8. “I wish staff would listen to me more”.

  9. The future… • Using the feedback – can all feedback go to our workgroup? Keeping it confidential. • Sustainability & back-up plans • Responding to consumers while in seclusion, eg long seclusion episodes. • Improving notification & response times

  10. With thanks to… • Consumer and Carer Engagement Service • Seclusion & restraint workgroup at The Park • Library staff, The Park For further details, please feel free to contact: andrew.strachan@health.qld.gov.au irene.francisco@health.qld.gov.au

  11. Related reading Cutliffe, J.R. & Riahi, S. (2013). Systemic perspective of violence and aggression in mental health care: Towards a more comprehensive understanding and conceptualization: Part 2. International Journal of Mental Health Nursing, 22, 568-578. Meehan, T., Vermeer, C. and Windsor, C. (2000). Patients’ perceptions of seclusion: a qualitative investigation. Journal of Advanced Nursing, 31(2), 370-377. Meehan, T., Bergen, H. & Fjeldsoe, K. (2004). Staff and patient perceptions of seclusion: has anything changed? Journal of Advanced Nursing, 47, 33-38. Petti, T.A., Mohr, W., Somers, J & Sims, L. (2001). Perceptions of seclusion and restraint by patients and staff in an intermediate-term care facility. Journal of child and adolescent psychiatric nursing, 14, 115-127. Ryan, R. & Happell, B. (2009). Learning from experience: Using action research to discover consumer needs in post-seclusion debriefing. International Journal of Mental Health Nursing, 18, 100-107.

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