Reducing the use of restrictive procedures in a residential facility

Restrictive procedures are frequently used in residential facilities for the mentally ill and developmentally disabled despite humanitarian, professional, and legal concerns. Administrators in a regional residential facility for the developmentally disabled instructed staff to reduce the use of seclusion, mechanical restraint, and psychotropic drugs in the facility and set clearly defined policies and procedures on the use of such restraints. Data were gathered on the prevalence of restrictive procedures before and after the new policies were implemented, and staff received frequent feedback. The data showed that in the two and a half years following the adoption of the new policies, the use of seclusion, mechanical restraint, and psychotropic drugs dropped significantly without a concomitant increase in violent incidents, staff turnover, or use of other restrictive procedures. The authors conclude that instructions and feedback are an effective and inexpensive way to reduce the use of restrictive treatment procedures and that the approach used in their facility merits further investigation.