Best practices: The development and implementation of "no force first" as a best practice

Area of Science:

• Behavioral Health
• Mental Health Treatment
• Patient Safety

Background:

• The mental health field faces ongoing challenges with seclusion and restraint practices.
• Recovery Innovations, Inc. (RI) is committed to recovery-oriented care.
• Previous success in eliminating seclusion and nonchemical restraints created an opportunity for further improvement.

Purpose of the Study:

• To evaluate the implementation of a "no force first" (NFF) policy targeting chemical restraint use.
• To assess the impact of the NFF policy in a crisis center setting.
• To determine the feasibility of adopting the NFF policy as a best practice across multiple behavioral health programs.

Main Methods:

• Implementation of a "no force first" (NFF) policy in a crisis center.
• Focus on reducing the use of chemical restraints.
• Concurrent adoption of the NFF policy across 19 behavioral health programs following successful pilot.

Main Results:

• Successful elimination of seclusion and nonchemical restraints in the crisis center.
• Significant reduction in the use of chemical restraints following NFF policy implementation.
• Widespread adoption of the NFF policy as a best practice throughout RI's programs.

Conclusions:

• The "no force first" (NFF) policy is an effective strategy for reducing restraint use in mental health settings.
• The NFF policy promotes a recovery-oriented approach to care.
• Successful implementation in one setting can lead to broader organizational change and improved patient safety.