S41: Innovation in Care Facilities

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By September 28, 2023 No Comments

Authors: Sarah Versitano, Iain Perkes, Artur Shvetcov, Joy Paton, Scott James, Vesna Ristic & Assuna schultz

Year: 2023

Event: 2023 The MHS conference - Adelaide

Subject: Innovation in Care Facilities

Type of resource: Video

Presentation 1: Art therapy is associated with a reduction in restrictive practices on an inpatient CAMHS unit.
Authors: Sarah Versitano, Iain Perkes, Artur Shvetcov & Joy Paton
The elimination of restrictive practices, particularly seclusion and restraint, is a major aim of mental health services globally. The role of art therapy, a predominantly non-verbal mode of creative expression, is currently under-explored in this context. Our retrospective study aimed to determine whether art therapy service provision was associated with a reduction in restrictive practices on an acute inpatient child and adolescent mental health services (CAMHS) unit.
The rate, frequency, duration, and total number of incidents of seclusion and restraint occurring between July 2015 – December 2021 were analysed in a naturalistic ABAB design. The rate, frequency and number of incidents of intramuscular injected (IM) sedation, oral PRN use, and absconding incidents occurring in conjunction with an episode of seclusion or restraint were also analysed.
Findings indicated a clear association between the provision of art therapy, and a statistically significant reduction in the prevalence of restrictive practices such as seclusion, physical restraint, and IM sedation. Our findings provide evidence for the importance of establishing creative therapeutic interventions in inpatient mental health settings. Specifically, the provision of permanent art therapy services in being able to support the prevention and reduction of harmful restrictive practices for children and adolescents.

Learning Objective
1. The importance of creative therapeutic interventions in supporting the reduction of restrictive practices in mental health services.
2. Our retrospective study examines the use of restrictive practices on an acute inpatient CAMHS unit in a metropolitan public hospital. However, findings are relevant for inpatient and community mental health services.

Braito, I., Rudd, T., Buyuktaskin, D., Ahmed, M., Glancy, C., & Mulligan, A. (2021). Review: systematic review of effectiveness of art psychotherapy in children with mental health disorders. Irish Journal of Medical Science (1971-), 1-15. https://doi.org/10.1007/s11845-021-02688-y
Duke, S. G., Scott, J., & Dean, A. J. (2014). Use of restrictive interventions in a child and adolescent inpatient unit–predictors of use and effect on patient outcomes. Australasian Psychiatry, 22(4), 360-365. https://doi.org/10.1177/1039856214532298 .

Presentation 2: “Rights” – Everyday practice for Independent Patient Rights Advisers and legislated expectations for inpatient facilities.
Author: Scott James
Queensland Health employs Independent Patient Rights Advisers (IPRA’s) to ensure patients, and their carers, are aware of their rights under the Queensland Mental Health Act 2016.
Patients, carers, clinicians and IPRA’s clearly see the benefits of focusing on “rights” within the inpatient settings. This presentation will provide the evidence of having a “rights approach” across all domains can assist individuals to:
• gain a better understanding of their rights
• increase their ability to communicate their views, wishes and preferences
• self advocate in their Mental Health Review Tribunal hearings.

By effectively engaging with individuals within inpatient settings, IPRA’s highlight the legislated expectations of “patient rights” and ensure these rights move from rhetoric to reality.
Advising individuals of their mental health “rights” facilitates positive collaboration and assists with identifying less restrictive ways of treatment and care (Mental Health Act 2016 Implementation Evaluation,2019). The presence of IPRA’s (or a focus on “rights”) has a positive impact on individuals experience of care (Connecting Care to Recovery – Evaluation,2021)

Learning Objective
1. Providing individuals with information about their rights can assist with a more collaborative approach to treatment and have a positive impact on an individual’s experience of care.
2. The presentation is focused on “rights” within mental health, specifically clinical care within inpatient settings.

Presentation 3: Supporting Emotional Wellness and Mental Health in Aged Care.
Authors: Vesna Ristic & Assuna schultz
People living in residential aged care facilities (RACFs) have had access to minimal mental health support. This is particularly confronting, given that the most recent Royal Commission into Aged Care Quality and Safety indicated that individuals living in RACFs experienced significant human rights violations and up to 50 percent of residents experienced symptoms of anxiety and depression, compared to 10 percent of older Australians in the community. In 2020, Relationships Australia South Australia was commissioned to deliver the Supporting Emotional Wellness in Aged Care program, providing free individual and group therapy services to people living in RACFs until June 2023. This presentation aims to bring attention to the human rights issues and the mental health needs of individuals in RACFs. We will explore the experiences of people living in RACFs, the complex landscape of the difficulties they experience, including mental health difficulties, and how our program has aimed to provide mental health support and education that is appropriately adapted, person-centred and challenges the longstanding ageism bias which continues to hold strong today. Join us in exploring how we can all make a difference to the lives of those who deserve it most.

Learning Objective
We will explore the human rights and mental health issues in RACFs through client experiences and our clinical findings. We will also explore strategies that can be implemented to support residents’ needs.

Amare, A.T., Caughey, G.E., Whitehead, C., Lang, C.E., Bray, S.C.E., Corlis, M., Visvanathan, R., Wesselingh, S. & Inacio, M. I. (2020). The prevalence, trends and determinants of mental health disorders in older Australians living in permanent residential aged care: Implications for policy and quality of aged care services. Australian & New Zealand Journal of Psychiatry, 54 (12), 1200-1211. https://doi.org/10.1177/0004867420945367.
Banerjee, D., Rabheru, K., Lima, C.A., & Ivbijaro, G.O. (2021). Role of dignity in mental health care: Impact on ageism and human rights of older persons. The American Journal of Geriatric Psychiatry, 29 (10), 1-9. doi: 10.1016/j.jagp.2021.05.011.

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