[The Model of Prevention of Seclusion and Restraint Use in Mental Health: An Integrative Review].
Bibliographic record
Abstract
Background Seclusion and restraint are still being used frequently in psychiatric and mental health care despite their known harmful effects. Many countries have the goal of reducing their use, leading to a number of research on prevention interventions. While many of these interventions have been shown to be effective, reducing restrictive practices depends on several factors. Conceptual models have been developed in relation to seclusion and restraint, but none have addressed their prevention specifically. Aim This article aims to propose The Model of prevention of seclusion and restraint use in mental health by carrying an integrative review on the subject. Methods An integrative review was conducted using Whittemore et Knafl's (2005) approach. Four databases (Pubmed, PsycINFO, EMBASE, CINAHL) were searched for publications between 2010 and 2020, in French or English. Search terms included seclusion, restraint, psychiatr*, mental health reduction and mental health prevent*. The search resulted in the inclusion of 138 articles. Data was analyzed using thematic analysis (Miles et coll., 2014) and categorized with Bronfenbrenner's (1979) ecological model. Results The six categories represented in the ecological model are described in terms of systems mutually involved in the prevention of seclusion and restraint use: the person (individual), the professionals and the physical environment (microsystem), the ward culture (mesosystem), organizational initiatives (exosystem), national policies and international organizations (macrosystem) and evolution of the discourse or resistance to change (chronosystem). Specific interventions are presented for each system, as well as their interactions. Conclusion The prevention of seclusion and restraint use in mental health is a shared responsibility between the systems involved, who must act as leaders and agents of change by implementing their specific activities. Preventing restrictive practices in mental health will be achieved by developing a shared responsibility and a shift towards a culture of partnership.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".