Massachusetts adopted the Policy #10-02, effective August 16, 2010. The policy establishes procedures and requirements for use of restraint and seclusion in the Department of Mental Health facilities and treatment programs. The policy is part of an effort to reduce the use of and eventually eliminate restraint and seclusion.
DMH is committed to the continuous evaluation of restraint and seclusion data, and to the ongoing use of targeted performance improvement initiatives. These actions will reinforce the prevention model, improve practice, lead to better outcomes and support the goal of eliminating the use of restraint and seclusion in DMH facilities and programs.
The policy elements below are designed to facilitate achievement of DMH’s goal to reduce and eventually eliminate the use of restraint and seclusion.
A. Physical Space: A room used for restraint and/or seclusion must be calm, quiet, have appropriate lighting, and afford comfort and maximum privacy to the patient. The facility must assure reasonable bathroom access and provide a reasonable way for the patient to mark the passage of time.
B. Dignity, Privacy and Safety: Staff must make every effort to respect the patient’s dignity and privacy, (e.g., maintain the patient’s dignity and privacy while he or she is using the bathroom) and ensure the patient’s safety while he or she is in restraint or seclusion.
C. Use of Mechanical and Physical Restraints: The determination as to which mechanical and/or physical restraints should be used must take into consideration a number of factors, including patient preference, the patient’s individual crisis prevention plan, medical safety and comfort.
Only staff with specific, current training and demonstrated competency as required in Section V.E. below in the use of these restraints or techniques may be involved in their application. Listed below are descriptions of specific primary and specialty restraints and techniques which can be used under certain conditions. These are the only restraints and techniques that have been approved by DMH for use pursuant to this policy. Improved restraints or techniques developed subsequent to the date of this policy may be used if approved by the Commissioner or his or her designee.
CPI Can Help!
Facilities across the US use the Nonviolent Crisis Intervention® training program because it's been shown to be effective in both the prevention of and the safe use of physical restraint. CPI training focuses on prevention and de-escalation techniques and other alternatives to restraint and seclusion, as well as how to use safer, less-restrictive physical interventions only as a last resort. Training gives staff tools to organize their thinking about risk behavior and help them determine the most appropriate, least restrictive intervention to use in each unique situation.
Tailoring Training to Your Needs
CPI training is flexible and can be tailored to the unique needs of your facility. With our train-the-trainer option, select staff can be certified to teach the program to other staff on a continuing basis. We also offer specialized materials to help connect the Nonviolent Crisis Intervention® training program skills and strategies with your PBIS plan to increase positive behavior.
How to Get Training
We can bring the Nonviolent Crisis Intervention® training program on site to your facility, or you can attend training in one of more than 150 public locations throughout the US.
If you’re already a Nonviolent Crisis Intervention® Certified Instructor, you can share strategies with your staff from our advanced course, Trauma-Informed Care: Implications for CPI's Crisis Development ModelSM. This course dives deep into the influence of trauma on behavior and offers additional strategies to help you better support individuals who have experienced traumatic events. Locate an upcoming public program or have us bring the training to you.