A new report released by the Substance Abuse and Mental Health Services Administration (SAMHSA), a program of the US Department of Health and Human Services, takes a different approach to the reasoning behind reducing the use of restraint and seclusion among our nation’s facilities and schools—one that makes sense financially.
Titled “The Business Case for Preventing and Reducing Restraint and Seclusion Use,” [PDF] the report provides exactly that—a case for the reduction of costs associated with the improper use of restraint and seclusion. We all know that reducing the use of restraint and seclusion makes sense from a care standpoint, but when finances come into play, will more organizations take notice?
After reviewing the costs associated with the use of restraint and seclusion events, as well as the benefits and savings reported by facilities that have limited their use, the report found that incidents of restraint and seclusion are expensive and largely due to preventable events. Not only that, the report says these incidents only contribute to a vicious cycle of violent events.
In a study cited in the report, workplace violence can take up as much as 23% to 53% of staff time, obviously an expense. These violent incidents, however, also account for 50% of staff injuries—very expensive for organizations to cover. These incidents lead to an overall higher cost of care for individuals, and greater liability costs for the organization itself.
Organizations that have successfully reduced the use of restraint and seclusion have used staff training to implement alternatives, and, as a result, enhanced their environments. “Many organizations have significantly increased staff supervision to support staff and help develop their crisis prevention skills,” the report says. Organizations have also experienced cost savings from reduced staff turnover.
As the report concludes, “Reducing and preventing their use can yield significant savings, enhance the quality of treatment, and result in increased satisfaction from those providing and receiving services.” This statement, combined with the increased safety and well-being for all in our care, sums it up perfectly—reduction of restraint and seclusion benefits everyone and every organization involved in the provision of care. If this isn’t enough to make them take notice, what is? What more evidence do we need to begin to address the improper use of seclusion and restraint more aggressively?
“The status quo is not acceptable and cannot be tolerated any longer,” says the report. “Despite the cost pressures, liability constraints, resistance to change and other seemingly insurmountable barriers, it is simply not acceptable for patients to be harmed by the same healthcare system that is supposed to offer healing and comfort.”
Now that we know this, we have to continually reinforce this message to administrators and others associated with our funding decisions for our training.