NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS

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