Restraint: Using a mechanical device to tie someone down or administering a psychotropic medication involuntarily

Seclusion: Placing someone involuntarily in isolation

The Players: Senior members of the Massachusetts Department of Mental Health's (DMH) clinical and administrative staff, most of whom have authorized, administered, and/or witnessed restraints and seclusion.

The Transformation Center, a nonprofit organization of people with mental health conditions and their advocates, most of whom have either been restrained or secluded or had a family member restrained or secluded.

 

The Challenge: After a federal initiative to elminate restraint and seclusion, the Massachusetts Department of Mental Health received funding to work on the issue. A key goal was to include input from patients, families, staff, and advocates. Although discussion about policy was possible, multiple attempts to have more personal conversations about the deeply complex and highly emotional issue failed. There were numerous complicating factors: the two disparate groups had never talked about the issue from a personal perspective; the danger of people feeling re-traumatized as they discussed these intense and sometimes traumatic experiences; and long-standing questions and concerns about these techniques as an effective and necessary means of keeping patients from hurting themselves, staff, and each other.

 

The Shift: The Public Conversations Project's charge: To help mental health advocates, people living with mental health conditions, and clinical staff speak about these emotionally charged experiences and develop the trust needed to work together to reduce the use of restraint and seclusion in Massachusetts. Through in-depth work with each group separately, PCP helped identify participants' hopes and fears and prepare them for a series of dialogues. When the two groups finally came together, they were able to share their personal stories and listen to each other in a new way. Relationships were transformed, communication was changed, and the two groups not only worked together, but went on to jointly design and hold a conference.

 

Click here to find out what The Transformation Center says about this work.