No abstract

Background: The elimination of seclusion and restraint, that is, restrictive practices, 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. Aims: 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 total number of incidents of restrictive practices occurring between July 2015 and December 2021 were analysed in an ABAB design. 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 decrease during phases of art therapy service provision. Conclusions: Art therapy service provision is associated with reduced use of restrictive practices in inpatient CAMHS.