Drivers of Seclusion and Physical Restraint in an Acute Mental Health Unit: A Feature Analysis

Esario Daguman IV; Alison Taylor; Matthew Flowers; Richard Lakeman; Marie Hutchinson

doi:10.1080/01612840.2025.2538705

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Drivers of Seclusion and Physical Restraint in an Acute Mental Health Unit: A Feature Analysis

Journal article

Open access

Peer reviewed

Drivers of Seclusion and Physical Restraint in an Acute Mental Health Unit: A Feature Analysis

Esario Daguman IV, Alison Taylor, Matthew Flowers, Richard Lakeman and Marie Hutchinson

Issues in mental health nursing, Vol.46(9), pp.937-947

05/09/2025

DOI: https://doi.org/10.1080/01612840.2025.2538705

PMID: 40911824

Appears in Recent Faculty of Health Publications

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Abstract

Understanding the drivers of seclusion and physical restraint supports the work towards minimising their use in acute mental health units. However, evidence on their most important drivers remains limited and is focused mainly on individual-level features. Employing 249 days of 917 contemporaneous records of nurse de-escalation events in one adult inpatient unit in regional Australia, from January 2019 to March 2020, twenty-three features other than individual demographic, dispositional, and diagnostic factors were extracted. Bivariate statistics and supervised machine learning algorithms for feature selection (i.e. Boruta algorithm) and predictive modelling (i.e. random forest) were applied. Emerging top drivers include incidents in high observation beds, the assessed level of situational aggression before de-escalation, incidents directed towards nurses, verbal de-escalation, and distraction and redirection. These findings elevate the predictive value of contextual and interventional, rather than individual-level, features in understanding the likelihood of restrictive practices.

Details

Title: Drivers of Seclusion and Physical Restraint in an Acute Mental Health Unit: A Feature Analysis
Creators: Esario Daguman IV - Southern Cross University
Alison Taylor - Coffs Harbour Base Hospital (NSW, Coffs Harbour)
Matthew Flowers - Coffs Harbour Base Hospital (NSW, Coffs Harbour)
Richard Lakeman - Southern Cross University
Marie Hutchinson - Southern Cross University
Publication Details: Issues in mental health nursing, Vol.46(9), pp.937-947
Publisher: Taylor & Francis
Number of pages: 11
Identifiers: 991013312224802368
Academic Unit: Office of the Vice Chancellor; Nursing; Faculty of Health
Language: English
Resource Type: Journal article