Accessible summary What is known on the subject? A relevant number of restraint prevention programmes have been developed internationally. In Spain, there is no harmonized policy to prevent the use of restraint. More studies are necessary to establish which programmes and components are necessary to prevent restraint. What does the paper add to existing knowledge? There was a significant decreasing trend in the total number of mechanical restraint hours during the implementation of the intervention. There was no significant decreasing trend in the number of mechanical restraint episodes. What are the implications for practice? Interventions at a regional level aimed at preventing mechanical restraint are feasible in the Spanish context. All components of the Six Core Strategies could be necessary to prevent episodes of mechanical restraint. Abstract IntroductionMechanical restraint (MR) is used in many countries, including Spain, where non‐harmonized policies between autonomous communities exist. There is a lack of research about interventions at regional levels to reduce their use. AimTo analyse data on key outcomes during the implementation of a multicomponent intervention in Andalusia (Spain) to reduce the use of MR. MethodEpisodes in a period of 30 months in all wards (N = 20) were analysed. The intervention consisted of five strategies: (a) leadership, (b) analysis of the situation, (c) awareness training for the heads of the wards, (d) unified record of MR and (e) staff training. We analysed the monthly trend of restraint hours and restraint episodes/1,000 bed days using segmented regression. ResultsThere were 206.32 restraint hours and 12.96 restraint episodes/1,000 bed days during the study period. A significant decreasing trend was observed in restraint hours (−1.79%, p < .001), but not in the number of restraint episodes (−0.45%; p = .149). DiscussionThe results coincide with other international studies; however, studies with better designs are required to evaluate the effectiveness of the intervention. Implications for PracticeInterventions at a regional level aimed at preventing MR are feasible in the Spanish context.

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Introduction: Factors associated with prolonged episodes of mechanical restraint and other coercive interventions are not clearly established and have been not studied in Andalusia (Spain).Aim: To study factors associated with prolonged episodes of mechanical restraint. Method:We analysed retrospectively episodes of mechanical restraint (N = 6267, prolonged episode >9.5 hours) in all public mental health hospitalization units (N = 20, 535 beds) that offer health coverage for the autonomous community of Andalusia.The data came from clinical records. A multivariable mixed logistic regression was used.

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EUREGENAS (European Regions Enforcing Against Suicide) is a project which has received funding from the European Union under the Public Health Programme 2008–2013. The overall objective of the project is to contribute to the prevention of suicidality (suicidal ideation, suicide attempts and suicide) in Europe through the development and implementation of strategies for suicide prevention at regional level that can be of use to the European Community as examples of good practice.The project has several workpackages (WP). Our region, Andalusia (Spain) is one of the eleven selected regions associated partners and has been selected for piloting three WPs (number 6, 7 and 8) in a high rate of suicide local area. The aims of the WP's are :WP 6: to develop general guidelines for suicide prevention strategies as well as specific prevention packages for the awareness raising on suicide prevention for the identified target groups.WP 7: to develop a training package targeting GPs and to pilot the training package in five selected regions/local areas. The main goal of the training is to provide GPs with relevant information related to the early detection/recognition and referral of suicide risk.WP8: to develop a specific tool for survivor support groups to support facilitators in ensuring an on-going monitoring of the group processes. This tool will be used in order to map the group status and to adjust the management of the group accordingly.In our communication we want to show the experience and results of the project in our area.