Comparing the outcomes of the application of C&R (general service) and SCIP in the management of disturbed behaviour in mental health care

Abstract

Background

Violence and aggression is common in mental health care and physical restraint is used frequently. Control and restraint (general services) (C&R (GS)) and Strategies in Crisis Intervention and Prevention (SCIP) are often used. There had not been any study evaluating the outcomes of the different approaches of restraint method.

Aim

To compare the effectiveness of C&R (GS) and SCIP.

Method

A retrospective cohort study design was employed to compare the rates of disturbed incidents. The patients admitted to C&R (GS) and SCIP wards were investigated to study the effectiveness of the two approaches of physical restraint.

Results

The study suggests that C&R (GS) achieved better outcomes than SCIP. Patients exposed to SCIP had longer hospitalisation, were involved in higher rate of incidents of disturbed behaviour; had lower survival and higher failure probabilities and a higher relative hazard ratio.

Conclusions

There is a need to debate the evidence base of the various approaches currently used in physical intervention in the management of disturbed behaviour by mental health services providers. The better outcomes demonstrated by C&R (GS) challenges the current trend in and the value of mental health practice.

Key words:

• physical restraint
• disturbed behaviour
• violence
• aggression

Acknowledgement

The authors of this paper are grateful to the sample sites that participated in the study and to the staff who collected the data.

Declaration of Interest: £40,000 scholarship money for this research was granted by the formal United Kingdom Central Council for Nurses, Midwives and Health Visiting for the first 2 years of the study. This paper does not pose any conflict of interest.