Forensic Psychiatric Hospital

Long Term Seclusion Pilot Project

Breakout D5: Rethinking Acute Mental Health Care

Ibrahim Abubakar BA Recreation Therapist

Forensic Psychiatric Hospital

Joey Fong MOT

Occupational Therapist Forensic Psychiatric Hospital

Presenter Disclosure • Presenters: Joey Fong, Occupational Therapist

Ibrahim Abubakar, Recreation Therapist

• Relationship with regulatory body: – College of Occupational Therapists of British Columbia – British Columbia Therapeutic Recreation Association

• Managing Potential Bias: – We have no conflict of interest or commercial

affiliation to disclose.

seclusion

occupational

deprivation

Recreation therapists

Occupational therapists

Physiotherapist

Reduce seclusion

Reduce violence

Engagement in meaningful activities

Off unit activities

Improve health/fitness

Reintegration

Positive Risk

Taking

Seclusion room

• Playing cards

• Reading magazines

• Board games

• Watching TV and videos

• Physiotherapy

• Walking

• Soccer

• Basketball

• Listening to music

• Cooked food

• Physiotherapy

• Treadmill

• Recumbent bike

• Music

• Basketball

• Volleyball

• Ping pong

• Working with other patients

• Fine and gross motor skills

• Responsible for caring for plants

Successes

• Increased time out of seclusion

• Engagement in regular programs

• Decrease violence/negative behaviour

• Improved health/fitness

• Improved social behaviour

• Change in staff attitudes

Seclusion room Regular room

Lessons we learned…

Challenges…

How do we get stakeholders on board?

How do we change attitudes / thinking?

Joey Fong Occupational Therapist

jfong@forensic.bc.ca

604-524-7794

Ibrahim Abubakar Recreation Therapist

IAbubakar@forensic.bc.ca

604-524-7928

References Ahmed, A. G., & Lepnurm, M. (2001). Seclusion practice in a Canadian forensic psychiatric hospital. Journal of the American

Academy of Psychiatry and the Law, 29(3), 303-309.

Ashcraft, L., & Anthony, W. (2008). Eliminating seclusion and restraint in recovery-oriented crisis services. Psychiatric Services, 59(10), 1198-1202.

Baum, C.M. and Edwards, D. (2001) Activity Card Sort (ACS). Test manual. Washington University School of Medicine, St. Louis.

Baum, C. & Edwards D. F. (2008). Activity Card Sort (2nd ed.). Bethesda, MD: American Occupational Therapy Association.

Beck, N. C., Durrett, C., Stinson, J., Coleman, J., Stuve, P., & Menditto, A. (2008). Trajectories of seclusion and restraint use at a state psychiatric hospital. Psychiatric Services, 59(9), 1027-1032.

Colton, D., & Xiong, H. (2010). Reducing seclusion and restraint: Questionnaire for organizational assessment. Journal of Psychiatric Practice®, 16(5), 358-362.

Fisher, A. G. & Jones, K. B. (2010). Assessment of Motor and Process Skills. Vol. 1: Development, Standardization, and Administration Manual (7th ed.) Fort Collins, CO: Three Star Press.

Georgieva, I., de Haan, G., Smith, W., & Mulder, C. L. (2010). Successful reduction of seclusion in a newly developed psychiatric intensive care unit. Journal of Psychiatric Intensive Care, 6(01), 31-38.

Haimowitz, S., Urff, J., & Huckshorn, K. A. (2006). Restraint and seclusion - A risk management guide.

References Huckshorn, K. A. (2004). Seclusion & Restraint. Where have we been? Where are we now? Where are we going? Journal of

Psychosocial Nursing, 42(9), 6-7.

Huckshorn, K. A. (2005). Six core strategies to reduce the use of seclusion and restraint planning tool: National Technical Assistance Center.

Huckshorn, K. A. (2006). Re-designing state mental health policy to prevent the use of seclusion and

restraint. Administration and Policy in Mental Health and Mental Health Services Research, 33(4), 482-491.

Keith, R. A. (1987). The functional independence measure: a new tool for rehabilitation. Advances in clinical rehabilitation, 2, 6-18.

Kielhofner, G. (2002). A model of human occupation: Theory and application: Lippincott Williams & Wilkins.

Kiresuk, T. J., & Sherman, M. R. E. (1968). Goal attainment scaling: A general method for evaluating comprehensive community mental health programs. Community mental health journal, 4(6), 443-453.

Maguire, T., Young, R., & Martin, T. (2012). Seclusion reduction in a forensic mental health setting. Journal of psychiatric and mental health nursing, 19(2), 97-106.

Ministry of Health. (2012). Secure rooms and seclusion standards and guidelines: A literature and evidence review.

Photo Credits • FPH Photo Archives • Ibrahim Abubakar • Joey Fong • https://jixifox.files.wordpress.com/2015/01/up

hill-climb-of-an-entrepreneur.jpg • http://sd.keepcalm-o-matic.co.uk/i/keep-calm-

and-set-new-goals.png • http://i.imgur.com/VHDOXll.jpg • https://advancingschizophreniatherapeutics.fil

es.wordpress.com/2015/01/window-of-tolerance.jpg

• http://www.snoezelen.info/wp-content/uploads/2014/09/HiRes.jpg

• http://fcpaprofessor.com/wp-content/ uploads/2016/05/lessonslearned.jpg

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