Factors influencing the de-implementation of seclusion and restraint in inpatient mental health settings: a qualitative systematic review protocol

Sophie Sergerie-Richard; Guillaume Fontaine; Lewys Beames; Vincent Billé; Rachael Laritz; Marie-Hélène Goulet

doi:10.11124/JBIES-24-00441

Factors influencing the de-implementation of seclusion and restraint in inpatient mental health settings: a qualitative systematic review protocol

JBI Evid Synth. 2025 Nov 1;23(11):2365-2375. doi: 10.11124/JBIES-24-00441. Epub 2025 Nov 6.

Authors

Sophie Sergerie-Richard^{1

2}, Guillaume Fontaine^{3

4

5

6}, Lewys Beames^{7

8}, Vincent Billé^{1

2}, Rachael Laritz⁶, Marie-Hélène Goulet^{1

2}

Affiliations

¹ Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.
² Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada.
³ Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
⁴ Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital, CIUSSS West-Central Montreal, Montréal, QC, Canada.
⁵ Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁶ Centre for Nursing Research, Sir Mortimer B. Davis Jewish General Hospital, CIUSSS West-Central Montreal, Montréal, QC, Canada.
⁷ King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
⁸ South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.

PMID: 40956061
DOI: 10.11124/JBIES-24-00441

Abstract

Objective: The objective of the review is to synthesize qualitative evidence on the views, experiences, and perspectives of service users and their informal carers, health care providers, managers, and decision-makers regarding factors influencing the de-implementation of seclusion and restraint in inpatient mental health settings.

Introduction: Seclusion and restraint, frequently used in mental health settings, are low-value health care interventions associated with numerous negative consequences and lack of therapeutic benefits. Conceptualizing the reduction, substitution, and elimination of these low-value interventions under the lens of de-implementation offers an innovative and promising approach.

Eligibility criteria: Qualitative studies exploring the views, experiences, and perspectives of adult mental health service users, their informal carers, health care providers, managers, and decision-makers regarding the de-implementation of seclusion and restraint will be considered for inclusion. Studies conducted in inpatient general mental health settings, excluding subspecialties, will be considered.

Methods: This review will follow the JBI methodology for qualitative reviews. The databases to be searched are CINAHL Complete (EBSCOhost), Cochrane Library, Embase (Ovid), MEDLINE (Ovid), PsycINFO (Ovid), and Web of Science. Study selection, data extraction, and quality assessment will be conducted independently by 2 authors. Following a meta-aggregation approach, the data synthesis will be guided by the Consolidated Framework for Implementation Research and the Model of Prevention of Seclusion and Restraint Use in Mental Health. Methodological quality will be assessed using the JBI Critical Appraisal Checklist for Qualitative Research, and confidence in the findings will be assessed using ConQual.

Review registration: PROSPERO CRD42024586670.

Keywords: de-implementation; mental health; qualitative research; restrictive measures; systematic review.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Inpatients* / psychology
Mental Disorders* / therapy
Mental Health Services*
Patient Isolation* / psychology
Qualitative Research
Restraint, Physical*
Systematic Reviews as Topic