The Joint Commission places a strong emphasis on reducing the use of restraints and seclusion in psychiatric hospitals and behavioral health care organizations. These settings play a vital role in offering care and support to individuals facing behavioral health challenges. However, the ethical concerns and potential harm associated with the use of restraint and seclusion as behavioral management techniques necessitate a shift toward safer and more effective care strategies.

Joint Commission Standards for Reducing Restraints and Seclusion

The Joint Commission Standards are designed to promote care delivery strategies that minimize the use of restraints and seclusion, with a focus on:

1. Person-Centered Care: The cornerstone of reducing restraint and seclusion lies in providing personalized care. Recognizing that each individual is unique, treatment plans should be tailored to their specific needs, preferences, and goals. By involving clients in decision-making and respecting their autonomy, staff can build trust and reduce the need for coercive measures.
2. Strength-Based Approaches: Shifting toward strength-based approaches involves focusing on an individuals positive attributes rather than their weaknesses. Staff members work collaboratively with individuals to identify coping strategies and support systems that empower them to manage their behaviors effectively. This reduces reliance on restraint or seclusion.
3. Trauma-Informed Care: Many individuals in behavioral health settings have experienced trauma, which can contribute to challenging behaviors. A trauma-informed approach acknowledges the impact of trauma on behavior and emphasizes safety, trustworthiness, choice, collaboration, and empowerment. Creating a trauma-informed environment helps clients feel secure and decreases the likelihood of aggressive behaviors.
4. Use of Alternatives: Behavioral health facilities should explore alternatives to restraint and seclusion, such as sensory rooms, calming spaces, and peer support. Offering clients alternative methods to cope with stress and agitation can significantly reduce the need for restraint or seclusion.

Staff Competencies for Reducing the Use of Restraints and Seclusion

The Joint Commission recognizes that comprehensive staff training and competency evaluation are crucial in reducing the use of restraints and seclusion:

• Comprehensive Training: Adequate training equips staff with the skills and knowledge required to handle challenging behaviors effectively. Training programs should emphasize de-escalation techniques, crisis prevention, and non-violent communication. Regular refreshers and continuous education boost staff confidence in managing situations without resorting to restraint or seclusion.

Performance Improvement and Data Utilization

The Joint Commission’s Performance Improvement standards offer guidance on using data to continually innovate strategies for reducing the use of restraints and seclusion:

• Continuous Monitoring and Evaluation: Regularly monitoring and evaluating the use of restraint and seclusion is crucial for identifying areas of improvement. Establishing a system to track incidents, analyze data, and implement changes based on findings fosters the development of more effective strategies.

In conclusion, reducing restraint and seclusion in behavioral health settings is both ethically imperative and a means of enhancing care quality. By implementing:

• Person-centered care
• Comprehensive training
• Strength-based approaches
• Trauma-informed care

… and alternatives, while continually monitoring and evaluating progress, behavioral health facilities create safer and more compassionate environments for individuals seeking support. 

Barrins & Associates Consultation

At Barrins & Associates we’ve incorporated Strategies for Reducing the Use of Restraints and Seclusion into our Mock Survey and Continuous Readiness Consultations. We continue to support your journey toward Joint Commission Accreditation and regulatory compliance.