Communication and Restraint Reduction (CaRR) Project

Project Title: The Role of Staff and Team Communication in Reducing Seclusion, Restraint and Forced Tranquilisation in Acute Inpatient Mental Health Settings.  CaRR is the short title and it stands for Communication and Restraint Reduction.

What is the main purpose of this study?

This study will identify the staff communication that characterises successful de-escalation of patients displaying aggressive behaviour in acute mental health settings, avoiding the need to use physical restraint (held to prevent movement), seclusion (locked in isolation) and forced tranquilisation (involuntarily injected with psychotropic medication).

Why are we doing this study?

In England, 80% of mental health nurses report experiencing aggression. Wards are under incredible pressure due to high bed occupancy rates and staff shortages. Patients are acutely unwell and often (40%) admitted involuntarily. Staff manage aggression using communication, known as de-escalation.

De-escalation is unsuccessful in one third of cases. When this happens, staff use restrictive practices including restraint, seclusion and forced tranquilisation. Such practices are potentially psychologically and physically harmful to both patients and staff.

De-escalation training is not evidence based and practice varies across individuals and teams.  By identifying the communication that characterises successful de-escalation this study will provide evidence to inform future training and improve practice.

CaRR Project Overview

This study is funded by the National Institute of Health Research (NIHR) and sponsored by East London NHS Foundation Trust (ELFT).

The study will take place in 4 different wards across ELFT and West London NHS Trust.

We will keep you up to date with our progresses and events, but feel free to contact us if you want more info about the study.