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Prevalence and correlates of restrictive interventions in an Irish child and adolescent psychiatric unit: a 4-year

Maeve Haran1,2, David Killeen3, Mike Healy4

  • 1Department of Psychiatry, School of Medicine, University College Dublin, Dublin, Ireland. maeve.haran@ucd.ie.

Irish Journal of Medical Science
|February 22, 2023
PubMed

Insights

This study examined restrictive interventions (RIs) in Irish child and adolescent mental health units. Higher rates of RIs were linked to factors like involuntary status, particularly in non-eating disorder patients.

Area of Science:

  • Child and Adolescent Psychiatry
  • Mental Health Services Research
  • Patient Safety

Background:

  • Global efforts aim to reduce restrictive interventions (RIs) in healthcare.
  • Understanding RI use in child and adolescent mental health is crucial for reduction strategies.
  • This study addresses a gap in research on RIs in Irish child and adolescent mental health settings.

Purpose of the Study:

  • To determine the prevalence and frequency of seclusion and physical restraints.
  • To identify demographic and clinical characteristics associated with RI use.
  • To analyze RI patterns in eating disorder and non-eating disorder patient groups.

Main Methods:

  • A 4-year retrospective study (2018-2021) of a child and adolescent psychiatric inpatient unit in Ireland.
  • Data collected via computer-based sheets and patient records.
  • Analysis of both eating disorder and non-eating disorder patient samples.

Main Results:

  • 6% of admissions involved seclusion, and 18% involved physical restraint.
  • Age, gender, and ethnicity were not significantly associated with RI rates.
  • Unemployment, prior hospitalization, involuntary legal status, and longer stay correlated with higher RIs in non-eating disorder patients; involuntary status was linked to physical restraint in eating disorder patients.

Conclusions:

  • Identifying at-risk youth for restrictive interventions enables early, targeted prevention strategies.
  • Findings highlight specific patient characteristics associated with increased RI use.
  • This research provides essential data for improving safety and care in child and adolescent mental health services.
Abstract

Keywords:
HospitalMental healthPhysical restraintSeclusionYouth

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