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Historic Conference |
By Sara Wildberger
A clear goal and focused plan to change a controversial practice in mental
health and related services emerged at a groundbreaking national
conference on May 5 in Washington, DC. Titled "A National Call to
Action: Eliminating the Use of Seclusion and Restraint," the conference
was sponsored by SAMHSA and the National Association of State Mental
Health Program Directors (NASMHPD).
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SAMHSA Administrator Charles G. Curie
© Greg Schaler 2003 |
"The use of seclusion and restraint clouds our vision and
impedes our mission," SAMHSA Administrator Charles G. Curie,
M.A., A.C.S.W., said in his conference address. "I have made
it a priority for SAMHSA to work with states, consumers of mental
health services, advocates, service providers, and provider organizations
ultimately to eliminate the use of such practices. Today we are
launching our national action plan to accomplish that goal."
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NASMHPD Executive Director Robert Glover
© Greg Schaler 2003 |
NASMHPD Executive Director Robert Glover, Ph.D., emphasized the
organization's position, issued in July 1999, that seclusion and
restraint are safety interventions of last resort and are not treatment
interventions, and that they "should never be used for the
purposes of discipline, coercion, staff convenience, or as a replacement
for adequate levels of staff or active treatment."
Conference participants included leaders from national mental
health organizations; professional and provider organizations; Federal,
state, and local mental health agencies; clinical training programs;
federally funded research, training, and technical assistance centers;
and mental health service consumers and people in recovery from
addictions and their family members. Participants examined solutions,
shared experiences and information, and contributed to a national
agenda, which SAMHSA will disseminate.
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Jacki McKinney
© Greg Schaler 2003 |
Jacki McKinney, M.S.W., advocate for the National Association of
People of Color Consumers, recounted a night in seclusion spent
listening to the man locked in the tiny room next door become increasingly
distressed, to the point of death. "Each time [an attendant]
came I said, 'I'm going to tell them about the man next door.' But
I couldn't, I was so scared for myself. Isn't this dehumanizing-to
force me to make a decision between my life and somebody else's?"
"The challenge we're still facing is addressing a culture
where people believe restraint helps," said Laura Prescott,
Executive Director and founder of Sister Witness International,
in remarks at the meeting.
Diverse viewpoints also found a forum. Lynn C. DeLacy, M.S., R.N.,
C.N.N.A., chair of the Task Force on Seclusion and Restraint for
the American Psychiatric Nurses Association, expressed concern,
in light of the national nursing shortage, about the labor-intensive
work required to prevent seclusion and restraint. Charles Riordan,
M.D., chair of the American Psychiatric Association's Committee
on Standards and Survey Procedures, predicted problems in eliminating
seclusion and restraint without a major commitment of money and
resources. He warned of possible unintended consequences of proposed
reporting requirements, such as hospitals' refusals to admit certain
patients.
The conference ended with a session in which participants submitted
recommendations for consideration in pursuing SAMHSA's National
Action Plan. 
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