Non-restrictive interventions to reduce self-harm amongst children in mental health inpatient settings: Systematic...

Area of Science:

• Child and Adolescent Psychiatry
• Mental Health Services Research
• Clinical Psychology

Background:

• Increasing rates of self-harm among children in mental health inpatient settings pose significant challenges.
• Policy guidelines advocate for minimizing restrictive practices for pediatric patients.
• There is a critical gap in understanding evidence-based alternatives to restrictive interventions.

Purpose of the Study:

• To identify proposed non-restrictive interventions for reducing child self-harm in inpatient mental health settings.
• To evaluate the existing evidence supporting the clinical application of these interventions.

Main Methods:

• A systematic literature search was performed across five major databases (CINAHL, Embase, Ovid MEDLINE, APA Psycinfo, Cochrane).
• Included articles reporting on non-restrictive interventions targeting self-harm in children within inpatient mental health facilities.
• Data were extracted and synthesized using narrative synthesis following quality assessment.

Main Results:

• The search yielded a small number of relevant articles (n=7), predominantly of low methodological quality.
• The theoretical underpinnings and proposed mechanisms of change for the identified interventions were frequently unclear.
• A significant lack of high-quality research currently informs clinical practice regarding non-restrictive interventions.

Conclusions:

• There is an urgent need for the development of effective, theoretically informed, non-restrictive interventions to address child self-harm in inpatient mental health services.
• Future intervention development should prioritize collaboration with individuals with lived experience.
• Enhanced research is crucial to guide clinical practice and improve patient safety.