Hogg Foundation for Mental Health

Group Formed to Provide Leadership to State in Reducing Seclusion and Restraint Use

March 1, 2007

Consumers, family members, mental health advocates, and representatives of private and public agencies have joined together to move Texas forward in reducing seclusion and restraint use.

The Hogg Foundation convened the Seclusion and Restraint Reduction Leadership Group on February 9 to provide leadership that will sustain momentum in the field generated by recent activities around the state. The group assessed the progress that has been made to date, and discussed ongoing needs for technical assistance to support facilities in reducing their seclusion and restraint use. They looked at ways to build on last September's Hogg Foundation-sponsored training and encourage participants to continue their seclusion and restraint reduction efforts.

Some attendees shared that a major struggle they have encountered is the resistance to cultural change among staff. They attributed this in part to the length of employment of staff members, especially those that have worked there a long time. Changing the way of doing things can be difficult and buy-in can take time.

Many of the facilities do not practice seclusion and are focusing efforts on reducing the use of restraint. Training and education are essential, but have been difficult to obtain and sustain on a continued basis. Providing education from the consumer's point of view is often effective. "Education is the key," said Mary Ryan, a leadership group member who has experienced seclusion and restraint. It is important that facility staff understand that "you are not the police and I am not the criminal," she said.

One facility reported changing language, calling mental health technicians "coaches" and replacing "rules" with "expectations." They hope this will encourage positive behavior and discourage children from breaking "rules."

The group also discussed ongoing policy barriers to seclusion and restraint reduction. The Leadership Group expressed the need for developing practical tools to replace seclusion and restraint.

The group will continue to meet periodically to support multiple efforts in the state to reduce the use of seclusion and restraint.