No-Restraint Committed General Hospital Psychiatric Units (SPDCs) in Italy-A Descriptive Organizational Study

Area of Science:

• Psychiatry and Mental Health
• Healthcare Management
• Human Rights in Healthcare

Background:

• Italy is a leader in deinstitutionalization and psychiatric reform.
• The application of no-restraint policies in General Hospital Psychiatric Units (GHPUs) is being explored globally.
• There is a growing need for humane and rights-respecting psychiatric care.

Purpose of the Study:

• To describe and explore the application of no-restraint policies in Italian GHPUs.
• To assess the organizational characteristics and effectiveness of these no-restraint practices.
• To contribute to the global discourse on humane psychiatric care.

Main Methods:

• A nationwide descriptive study using purposive sampling.
• A detailed online survey with 60 items across seven sections distributed to 24 GHPUs.
• Data collected on structural, organizational, and operational dimensions, and restraint episode management.

Main Results:

• Significant commitment to no-restraint policies observed, with 14 GHPUs reporting zero restraint incidents in 2022.
• Systematic procedures and risk management training are common, aimed at reducing coercive practices.
• A correlation found between exclusive garden spaces and increased restraint incidence.

Conclusions:

• No-restraint practices are viable and ethically aligned within psychiatric care.
• Organizational protocols and comprehensive training are crucial for successful restraint-free environments.
• The study supports a paradigm shift towards more humane and rights-respecting psychiatric care.