Mental Health Unit training in Violence Reduction and Restraint Minimisation
Mental Health Unit Case: an ‘open’ psychiatric unit with separate male and female wards, delivering services in a highly multi-cultural/multi-ethnic/multi-national environment.
Who engaged Dynamis:
the nurse-manager in charge of the psychiatric unit initially wanted his own staff trained, and ultimately also included members of the emergency department and the hospital security team in the training in order to promote a uniform understanding and approach to violence and aggression in the hospital.
Our initial analysis for this unique Mental Health Unit:
- this training would need to be very comprehensive in order to be able to provide the staff with solutions to the very varied intensity, seriousness and frequency of conflict which they experience in their work.
- training would need to cover the widely varying threat levels presented by varying clients and in the different settings in which they may present those behaviours (ambulance emergencies, community mental health, psychiatric unit, emergency department, ICU and so on)
- Cultural issues about touch, gender, rights and responsibilities would need to be addressed in the training – robustness of rules and their ability to be applied in different circumstances while maintaining integrity and usefulness would be paramount.
Why Dynamis was asked to help:
- there was no prior training in restraint procedures, rules of restraint or techniques at this Mental Health Unit
- no common model for de-escalation of conflict with service users within the Mental Health Unit
- teamwork and attitudes to restraint vastly different across the team who have been working in the Mental Health Unit for a long time
A highly qualified and experienced team of Dynamis trainers were deployed to this client to provide a tailored programme of training within the Mental Health Unit. With a view to assisting the hospital to meet international standards in healthcare and patient safety, the team matched standards in UK law, mental health practice and those of the Joint Commission and UN Human Rights for the programme. Physical skills development, in line with the above, enabled the staff to drastically increase the professionalism with which they managed the risks of violence and aggression in their settings.
Outcomes for this Mental Health Unit:
Staff reported a 95% satisfaction rating with the training, commenting often on how they had never been shown ways in which to control agitated clients with care and sensitivity, respect and maintaining dignity, before this programme began. The hospital passed its JCIA inspections, having had its procedures on patient restraint examined in detail. Inappropriate use of mechanical restraint devices declined by 90% following this training programme.