Alternatives to Seclusion and Restraint Initiative Briefings

	Informational Briefing for State Mental Health Commissioners and MH Facility Directors - 2008
	Beth Caldwell, MS Janice LeBel, EdD/PhD Kevin Huckshorn, RN, MSN, CAP Purpose: The purpose of this informational tool is to provide senior mental health executive leaders with available resources to use on work that is focused on preventing violence, trauma, and the use of seclusion and restraint. This resource tool is organized as a cross-walk for senior leaders, specific to their role [state official or facility director]. A senior level leader has only to find the row that best fits their current role to find specific resources listed that are targeted to him or her. Available resources are organized into the most accurate, literature supported categories known to date; these categories include leadership tasks, roles, and responsibilities; recommended data measures, data dissemination examples, and examples about what data can demonstrate; workforce development resources including examples of job functions and competencies, available training, and information about vendor models; specific assessment and treatment tools, policy and procedures; consumer inclusion strategies, roles, job descriptions; and debriefing policies, procedures, checklists. Model projects are also listed with contact information as well as other references and resources that may be of use.
	Resources by Category (Project Table)
I. Leadership Strategies	I.1 State Mental Health Commissioners/Directors: State Philosophy or Policy Statement on a) SR prevention and b) Trauma Informed Care (TIC) PA Bulletin RS 2005 MA RS Philosophy Statement ART GAO Report ART AKB Transform and Trauma Hodas S-R-Point-Counterpoint
	I.A Mental Health Facility Directors/Superintendents: Facility Philosophy or Policy Statement on a) SR Prevention and b) Trauma Informed Care NASMHPD SR Forensic Policy PA SR OMHSAS NASMHPD Trauma Position Brandenburg NV SR Policy 2003 APNA SR Position Statement Final MA DMH SR Policy Tools SR Massachusetts Adolescent Service Philosophy Statement Three Rivers Milieu Treatment Philosophy
	I.2 State Regulations on a) SR use, and b) Trauma Informed Care Hodas S-R-Point-Counterpoint California Morrison SR Schools NY Regs pc701 PA OMHSAS S-R Bulleton PA PRN & STAT Policy MA Reg_104cmr27 PA Policy Bulletin Prone VA NMHI Seclusion or Restraint Policies NVMHI Guidelines for Seclusion NVMHI SR Flowsheets VA NMHI Seclusion Restraint Children's Health Act of 2000 SR Tools DE Tools Riverview ME SR PP SR Patton State Hospital Trauma Planning Template
	I.B Facillity SR Rregulations on a) SR use, and B) Trauma Informed Care Cambridge Child Assessment Unit Physical Hold and Restraint Policy - 2005 VA NMHI Seclusion or Restraint Policies NVMHI SR Flowsheets VA NMHI Seclusion Restraint Children's Health Act of 2000 SR Tools DE Tools Riverview ME SR PP SR Patton State Hospital Trauma Planning Template CMS SR Rules Art Haimowitz Management Guide for Attorneys Medscape Patient Safety in MH CMS
	I.3 State Contractual Expectations on a) SR use and b) TIC for contracted providers MA Commissioners Kick Off Letter MA Medical Directors Kick Off Letter MA DMH Adult Commissioner Service Posting Art Haimowitz Management Guide for Attorneys Medscape Patient Safety in MH CMS SR NETI Planning Template
	I.C Faclility Assignment of a Task Force and Subcommittees with Strategic Reduction Plan and Goals SR NETI Planning Template
	I.4 Legislative Procedures and Process 14 Factors Fleischner SR Fleischner 14 Elements of a Good Restraint Law Fulton SH Focus on Safety Strategic Plan Hayes NDRN Successful Legislative Strategies (TX)
	I.5 Interagency Efforts with Other State Agencies Licensing Mental Health Programs/Facilities MA ED Best Practice Guidelines MA ED Final Practice Recommendations - 2006 Fleischner Model Restraint Statute- Annotated NY State Interagency Restraint Report
	I.F Facility Staff Recognition Programs for Best Practices in Reducing SR or Implementing TIC MA Westboro State Hospital Employee Awards
II. Data Usage	II.4 & II.D What data? FL Chemical Restraint Tracking Sheet
III. Workforce Development	III.1 Statewide General Staff Training Outline and Workforce Curriculum Pertaining Only to Recovery, Trauma Informed Care, Violence Prevention, and SR Reduction Art Hodas Direct Care Worker Nachsma Roadmap Overview Workforce Development Drilling Down on Workforce Development National and International Handling the Most Difficult 10%
	III.A Basic Facility Staff Orientation and Training Outline and Curriculum Pertaining Only to Recovery, Trauma Informed Care, Violence Prevention, SR Reduction ART AACP Recovery Guidelines Nachsma Roadmap Overview Workforce Development Drilling Down on Workforce Development
	III.B Examples of Facility Staff Job Descriptions and Competencies Relating to SR or TIC Cambridge Child Assessment Unit Escorts and Physical Holds Competency Massachusetts Lead Milieu Counselor Massachusetts LPN Massachusetts Milieu Counselor Massuchusetts Nurse Professional
	III.3 Aggression Control Training Vendor National and Internations Handling the Most Difficult 10%
IV. Consumer/Family Inclusion	IV.1 & IV.A Policies on Hiring Peers as Staff in State Offices & Facilities ART Peer Involvement MA SR SIG Project Mead Defining Peer Support ART Paving New Ground MA Consumer Programs
	IV.2 & IV.B Policies on Including Families and Advocates ART Paving New Ground MA Consumer Programs Cambridge Child Assessment Unit Parent Assessment for New Admission
	IV.C Specific Peer or Familiy Roles Amistad Peer Specialist Role MA Debriefer Patient Liaison Form
V. Prevention Tools	V. 1 & V.A Risk Assessments (Medical/Physical; Trauma, Conflict Triggers, Falls, Violence) [including forms] Champaign Weighted Blanket Assessing Violence Risk in Psychiatric Inpatients SR Tools MAVAS Violence SR Tools Psychiatric Emergency Flow Sheet Frank DiCataldos Trauma Experience Scale Tools TN MMHI Nursing Assessment Tool Nuring Assessment Child Adolescent Self-Harming Behavior Form Child Adolescent Sex Abusing Behavior Form Child Adolescent Violent Behavior Form
	V.2 Safety Planning/Crisis Planning [including forms] - for State Mental Health Commissioner/Directors Champaign Weighted Blanket MA Adult Safety Tool MA DMH The Safety Zone Tool SR Tool Restrictive Intervention Debriefing Inventory
	V.B Safety Planning/Crisis Planning [including forms] - for Mental Health Facility Directors/Superintendents Champaign Weighted Blanket SR TOOL Restrictive Intervention Debriefing Inventory Tewksbury SH - Adult Safety Tool BMC Personal De-escalation Plan Sensory Modulation Equipment and Links to Stores MA DMH Latency Safety Tool MA DMH Latency Trigger Tool MA DMH Latency Warning Sign Tool Noble Hospital Safety and Crisis Plan
	V.a Safety Planning/Crisis Planning [including forms] - for Consumers Paving New Ground - Peers Working In In-Patient Settings Satisfaction Dialogue Focus Group Guidelines 12th Version Family-Driven Care Highlights Family-Driven Care Position PYT What-We-Learned Youth Move Vision Youth Guided Link 1 Youth Guided Link 2
	V.3 Person Driven Planning State Policy Tools NC Person Centered Plan Gordon Harper Re-Inventing Treatment Planning IAPSRS Language Guidelines Tools NC Regulations PCP Instructions
	V.C Facility Specific Person Driven Planning Policies and Procedures Massachusetts Pre-Witnessing Protocol Child Treatment Map MA DMH Safety Tool Guidelines Tools NC Person Centered Plan Gordon Harper Re-Inventing Treatment Planning IAPSRS Language Guidelines Tools NC Regulations PCP Instructions
VI. Debriefing Procedures	VI.1 State Policies and Procedures on Debriefing After SR Events Assessing Violence Risk in Psychiatric Inpatients MA DMH Trauma Assessment Adult Debriefing
	VI.B Facility Debriefing Forms MA PT Debriefing & Comment Form
	VI.E Facility Performance Improvement SR Activities, What is Measured, How Often Reported, and to Whom MA RS Quality Monitoring Tool
VII. Model State Programs	VII.2 Public Sector - Adult Non-Acute: Worcester State Hospital MA DMH Project Westborough and Taunton Highlighted Model Andrus Children's Center Success Story MT RS Data 2001-2008 Success Real Reduction SFSH (FL) Success MO Fulton SH SR Rate Injuries 2007 HSRI Fast Facts SR Success Story SR John Hopkins July 2008 Elagent Health TIC Statistics
VIII. Other Non-State Run Facilities	VIII. A Non-State Run Facilities Success Story Madden SR Rates Success Story NY Linden Hill SR Data FL Moran Real Reduction TN Lutthren Homes Real Reduction Experience (Bailey)
IX. Additional Resources/Toolkit	IX.A Additional Resources/Toolkit MASTER Refs 2008 Children's Health Act 2000 SR CMS Final Rule 2006 CMS RTF Interm Final Rule 2001 GAO Report on Residential Treatment Centers GAO Restraint Testimony 1999 OIG RS Death Reporting 2006

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Alternatives to Seclusion and Restraint Initiative Briefings