Art therapy is associated with a reduction in restrictive practices on an inpatient child and adolescent mental health unit

J Ment Health. 2024 Apr 7:1-9. doi: 10.1080/09638237.2024.2332813. Online ahead of print.

Abstract

Background: The elimination of restrictive practices, such as seclusion and restraint, is a major aim of mental health services globally. The role of art therapy, a predominantly non-verbal mode of creative expression, is under-explored in this context. This research aimed to determine whether art therapy service provision was associated with a reduction in restrictive practices on an acute inpatient child and adolescent mental health services (CAMHS) unit.

Methods: The rate (events per 1,000 occupied bed days), frequency (percent of admitted care episodes with incident), duration, and number of incidents of restrictive practices occurring between July 2015 and December 2021 were analysed relative to art therapy service provision. The rate, frequency and number of incidents of intramuscular injected (IM) sedation, oral PRN (as-needed medication) use, and absconding incidents occurring in conjunction with an episode of seclusion or restraint were also analysed.

Results: The rate, frequency, duration, and total number of incidents of seclusion, the frequency and total number of incidents of physical restraint, and the rate, frequency and total number of incidents of IM sedation showed a statistically significant reduction during phases of art therapy service provision.

Conclusions: Art therapy service provision is associated with a reduction in restrictive practices in inpatient CAMHS.

Keywords: Art therapy; child and adolescent; inpatient mental health; mental health; restrictive practices; seclusion and restraint.