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Uncovering Complexities in Reducing Aggression, Conflict and Restrictive Practices in Acute Mental Healthcare Settings: An Overview of Reviews

Overview

This systematic review analyzed four studies examining nonpharmacological interventions to reduce aggression, conflict, and restrictive practices in acute mental health settings. Combined interventions like Safewards and Six Core Strategy showed effectiveness, while standalone staff training and sensory rooms had mixed results. Successful implementation requires multiple factors including stakeholder involvement and contextual considerations.

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Key insights

Key Insights:

  1. Combined interventions more effective than standalone approaches for reducing restrictive practices

  2. Staff training alone shows mixed results, needs integration with comprehensive approaches

  3. Safewards interventions consistently reduced conflict events and containment measures across studies

  4. Sensory rooms and equipment effectiveness remains inconclusive with mixed research outcomes

  5. Implementation success requires stakeholder involvement, preparation, planning, and contextual adaptation factors

  6. Evidence quality critically low across all reviews, limiting reliable conclusions

  7. Service user and peer worker involvement minimal, needs prioritization

Did this resource draw on transformative evidence?

<p>This resource is <strong>not</strong> based on experiential expertise. It&#39;s an academic systematic review analyzing four published studies using traditional research methodologies. The authors explicitly note the <strong>absence</strong> of meaningful involvement from service users and peer workers who possess lived experience. They recommend prioritizing experiential expertise in future interventions, stating that service users and peer workers can offer crucial insights into needs and preferences through their lived experiences.</p>
<p>This resource has <strong>limited</strong> grounding in practice wisdom. While it synthesises evidence from clinical practice settings and identifies implementation factors cited by practitioners (like staff training, stakeholder engagement, contextual adaptation), it primarily relies on formal research methodologies rather than frontline practice knowledge. The authors acknowledge this limitation and call for more "pragmatic knowledge bases" that incorporate practitioner experiences alongside traditional evidence to better understand real-world service change initiatives.</p>
<p>This resource is <strong>entirely</strong> based on research and evaluation insights. It&#39;s a systematic overview analyzing four published systematic reviews, synthesizing evidence from 23 primary studies across nine countries. The methodology follows rigorous Cochrane guidelines, employs standardized quality assessment tools (AMSTAR 2), and uses systematic data extraction and analysis. However, the authors note critically low evidence quality and recommend future research employ more robust methodologies, consistent outcome measures, and comprehensive documentation.</p>

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Categories

Resource type

Systematic Review