Shattering the Silence: Seclusion and Restraint as Retraumatizing Acts in the Lives of Women with Psychiatric Diagnoses
Laura Prescott, Sister Witness International

The incidence of childhood sexual and physical abuse in the lives of women across service sectors is so pervasive it has been described as a "normative female experience". Prevalence rates among women range from 50-75% of those in contact with mental health systems, 90% of those incarcerated; 70%-90% receiving substance abuse services, and 75% among girls adjudicated as delinquent by courts. This presentation uses a first-person account format to describe the long-term effect of these experiences and the ways restraint and seclusion act to remobilize cycles of trauma for people with psychiatric diagnoses. It outlines the need and suggests tools for proactive, trauma-sensitive, client-centered approaches in policy and practice in order to interrupt cycles of retraumatization and recidivism and create safer environments for clients and staff.

How Do We Get There from Here?
Aaryce Hayes, Advocacy Inc.

This presentation examines current practices in Texas related to the use of seclusion and restraint, highlighting similarities and differences in various organizations and service systems. It reviews and compares federal and state regulations that provide standards governing the use of seclusion and restraint. Finally, it suggests modifications in vocabulary, data collection methods, and relevant regulations that would increase communication across systems and states.

The State’s Role in Supporting the Change of Organizational Culture
Rep. Elliott Naishtat, Texas House of Representatives

Research indicates that successfully reducing the use of restraint and seclusion involves a change in the culture of care. The state can facilitate this change by clearly articulating its expectations around agencies’ use of restraint and seclusion. In the absence of clear guidance, agencies and providers develop individualized approaches that limit communication and progress across settings. Additionally, while it is possible to change agency culture without additional dollars, unfunded mandates are viewed with skepticism. This presentation will share ideas about ways the state can facilitate culture change across agencies and populations.

Luncheon and Keynote Address

Best Practice Approaches and Resources for Changing Agencies’ Culture and Reducing the Use of Emergency Procedures
Lloyd Bullard , Child Welfare League of America

Mr. Bullard will address the paradox that currently exists between the use of restraint/seclusion and the fact that kids and staff dislike the procedures equally. He will also highlight the best practice approaches and resources developed through Child Welfare League of America’s multi-site evaluation project completed this year.

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Break

Safely Managing Tough Situations
Joel Dvoskin, University of Arizona College of Medicine

In this highly interactive session, Dr. Dvoskin will reenact the most difficult and possibly violent situations that audience members have faced, as described by attendees at the session and as submitted by participants prior to the conference. Acting as team members, the audience will collectively assess the crisis, develop and weigh alternatives, and decide how best to resolve the situation with the least risk of harm to consumers and staff. Discussion will them focus on prevention -- steps that will help to reduce the possibility of similar crises with that consumer in the future.

Break

Concurrent Breakout Session 1

Skinning Cats: Trainers Learn From Each Other
Joel Dvoskin, University of Arizona College of Medicine

There are many ways to safely resolve crises, and every school of training has its strengths and weaknesses. Using hypothetical cases of potential violence, Dr. Dvoskin will prompt four different providers of training programs, each describing how they would train staff to respond. The audience will learn similarities and differences between different types of training, identifying the strengths and weaknesses of each approach. We will also discuss the types of people and situations that are best served by one approach versus another.

Concurrent Breakout Session 2

Funding that Works for Communities: Creative Strategies
for Generating Resources
Allison Supancic, Reymundo Rodriguez, Carolyn Young
Hogg Foundation for Mental Health

In a changing economic landscape and funding environment, it is vitally important that communities be prepared to connect with potential funding resources at all levels. Using timely information and real-life examples, this panel presentation will address the need for agencies and community-based organizations to plan creatively and strategically in order to seek resources and sustainable funding for programs and services and to meet the special needs of diverse communities. Panelists will offer three perspectives on sustaining services in a new and different environment of curtailed funding and agency realignments: creating new community partnerships; mobilizing economic and human resources; and identifying non-traditional funding opportunities. This will be accomplished by using timely information, anecdotal information from the presenters' perspectives, real-life experiences, and hand-out materials.