Australian Occupational Therapists responses to an online survey about restraint and seclusion in Adult Acute Mental Health Inpatient Units

Mrs Luciana Theodoro De Freitas1, Adjunct Professor Tilley Pain1

1Queensland Health, Townsville,, Australia

Background: Restraint and Seclusion (R&S) are still widely used amongst psychiatric services around the world including Australia despite efforts to reduce them. Emerging evidence suggests Sensory Modulation (SM) improves self-regulation for the mentally ill person and is a safe and an effective intervention which decreases the use of R&S in inpatient settings. Although Occupational Therapists (OTs) have taken the lead internationally in the implementation of these interventions, there is limited evidence that Australian OTs are trained, or are using SM.  This project explored OT’ practices in supporting the multidisciplinary team in Adult Acute Mental Health Inpatient Units (AAMHIU) to reduce R&S.

Methods: A questionnaire was created specifically for this study. Occupational Therapy Australia Association disseminated the online survey and snowball sampling was used to increase number of participants. IBM SPSS statistics package Version 24 was used to analyse categorical data. Free text responses were analysed using qualitative content analysis.

Results: Thirty-Three OTs responded to the survey. Findings showed most respondents were senior females working in a full-time position in the public sector, and had participated in formal SM training. These participants had four years or less of experience in their position at the AAMHIU. Respondents used sensory assessments and interventions in their clinical workload to support the multidisciplinary team to minimise R&S incidents. The court yard was the environment most frequently used to mitigate R&S incidents. Analysis of the open-ended questions indicate barriers to sustainable SM implementation include education, funding, environment modifications and workplace culture.

Conclusion: OTs in Australia have a significant role in supporting the multidisciplinary team to reduce or eliminate R&S in AAMHIU. Individual or group SM interventions are used by OTs to minimise R&S incidents. However, further research is recommended to identify which sensory intervention or tool is most appropriate for this setting.


Luciana is a passionate Occupational Therapist currently employed as a Clinical Research Coordinator in Queensland Health.  She has a strong commitment for evidence based approaches and values research through clinical experiences. She is highly interested in research within aged care and adult mental health population.

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