Abstract for: Co-designing restrictive practice elimination: A systems thinking approach with mental health service users and practitioners

There has been increased international drive for the reduction and or elimination of restrictive practices (physical/mechanical restraint and seclusion) from adult acute mental health care services for many decades. This study aimed to: (1) Identify priority issues influencing the use of alternative approaches to restrictive practices (seclusion and physical/mechanical restraint) in rural/regional acute adult mental healthcare services, as told by mental healthcare service users and practitioners themselves, (2) Identify the community-based, system-level feedback loops that enhance or reduce the use of alternative approaches to restrictive practices (seclusion and physical/mechanical restraint) and (3) Identify potential action areas to improve system structures to increase regional mental healthcare services’ ability to use alternative approaches to restrictive practices. Group Model Building (GMB) workshops were held with a small group (n = 9) of mental healthcare practitioners and service users with lived experience of restrictive practice use (physical/mechanical restraint and seclusion) in adult acute mental healthcare services. This participatory approach permits exploration and visual mapping of local structures causing behaviour patterns of practitioner and service user concern over time – in this case, the barriers, and enablers to alternative approaches to restrictive practices in adult acute mental healthcare services within the Geelong-Barwon region.