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Discrepancies in classification and reporting of restrictive practices (restraints, seclusion and other coercive measures) in mental health services

2026-05-11Artigo científico Acesso aberto
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dc.contributor.authorBelayneh, Zelalem
dc.contributor.authorLee, Den Ching A.
dc.contributor.authorPetrakis, Melissa
dc.contributor.authorAluh, Deborah
dc.contributor.authorOnu, Justus Uchenna
dc.contributor.authorNewton-Howes, Giles
dc.contributor.authorMasters, Kim
dc.contributor.authorKohn, Yoav
dc.contributor.authorSin, Jacqueline
dc.contributor.authorGoulet, Marie Hélène
dc.contributor.authorHusum, Tonje Lossius
dc.contributor.authorJelastopulu, Eleni
dc.contributor.authorBakola, Maria
dc.contributor.authorLeung, Sau Fong
dc.contributor.authorDe Cuyper, Kathleen
dc.contributor.authorMuir-Cochrane, Eimear
dc.contributor.authorCanteloupe, Yana
dc.contributor.authorDiviney, Emer
dc.contributor.authorBarr, Lesley
dc.contributor.authorRidley, Jim
dc.contributor.authorDemassosso, Didier
dc.contributor.authorHaines, Terry P.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblCambridge University Press
dc.date.accessioned2026-05-28T15:34:02Z
dc.date.available2026-05-28T15:34:02Z
dc.date.issued2026-05-11
dc.descriptionPublisher Copyright: © The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists.
dc.description.abstractBackground Global initiatives to reduce restrictive practices in mental health settings have gained increasing attention. However, discrepancies in restrictive practice rates create uncertainties about whether these variations reflect true differences in clinical practices or arise from inconsistent classification and reporting methods. Aims This study investigated how healthcare professionals classify and report potential restrictive practice scenarios, and examined variations in classification and documentation across diverse facilities. Method This was an international survey conducted using an online questionnaire via the Qualtrics platform. Healthcare professionals working in adult mental health in-patient settings were recruited through multiple media platforms and snowball sampling. The questionnaire included 44 potential restrictive practice case scenarios. Participants rated each scenario as follows: (a) whether it should be classified as a restrictive practice; (b) whether it should be recorded as such; (c) whether it would be classified as a restrictive practice within their facility; and (d) whether it would be reported as a restrictive practice in their facility. Survey development was guided by systematic reviews and co-design work with stakeholders. Data were analysed using ordered regression models, with clustering by participant identity and country. Robust standard errors were applied to ensure accurate estimation of variability. Results A total of 491 healthcare professionals from 41 countries participated. Results indicated substantial inconsistencies in clinicians’ perspectives regarding what constitutes restrictive practices and whether a given action should be reported as a restrictive practice. Although participants frequently identified scenarios as restrictive practices, their intention to report them was considerably lower. Additional discrepancies were observed between clinicians’ individual perspectives and their expectations of how these practices were actually being classified and reported as restrictive practices within the in-patient facilities where they work. Conclusions Discrepancies between healthcare professionals’ classification of restrictive practices and their reporting intentions, as well as between their perspectives and actual institutional practices, highlight potential errors in current reporting systems. These findings underscore the need for standardised definitions, enhanced reporting frameworks and structured training programmes and monitoring mechanisms to improve consistency in the management of restrictive practices across mental health settings.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent715834
dc.identifier.doi10.1192/bjo.2026.11040
dc.identifier.issn2056-4724
dc.identifier.otherPURE: 163574978
dc.identifier.otherPURE UUID: 713a903d-e428-4759-82f6-667894a20219
dc.identifier.otherScopus: 105039178487
dc.identifier.urihttp://hdl.handle.net/10362/203556
dc.identifier.urlhttps://www.scopus.com/pages/publications/105039178487
dc.language.isoeng
dc.peerreviewedyes
dc.subjectdefinition
dc.subjectmental health
dc.subjectRestraint
dc.subjectrestrictive practice
dc.subjectseclusion
dc.subjectPsychiatry and Mental health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleDiscrepancies in classification and reporting of restrictive practices (restraints, seclusion and other coercive measures) in mental health servicesen
dc.title.subtitlemulti-scenario analysis of an international surveyen
dc.typejournal article
degois.publication.issue3
degois.publication.titleBJPSYCH OPEN
degois.publication.volume12
dspace.entity.typePublication
rcaap.rightsopenAccess

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