In 1998, 11-year-old Andrew McClain was physically restrained while he was a patient at a psychiatric hospital in Connecticut. Two staff members tried to calm the 90-pound child’s aggressive tantrum by sitting on his chest, crushing and suffocating him to death. The event spurred a national examination of restraint use in mental health settings. Physical restraint has caused injury, further psychological trauma, and as in Andrew’s case, even death. Psychiatric nurses are trained to address problems with mentally disturbed patients, but sadly, often only identify them by their abuse, aggression, substance dependence, or detachment, causing them to live up to these expectations. Using restraints on these people, and in particular, those who have suffered torture or physical control usually exacerbates these symptoms, escalating the tension for staff and clients.
Dr. Kim Sivak, Director of Nursing at Delaware Psychiatric Center, believes that clients who struggle with anger, anxiety, depression, aggression, and violence should be permitted to work through these issues in a safe and encouraging environment. Stimulating the senses, rather than stifling them, gives suffering clients the opportunity to explore healthy coping strategies in a sheltered atmosphere with healthy boundaries. Comfort rooms are just such places. Designed to be a sanctuary for clients during their most tumultuous times, comfort rooms provide an alternative to restraints. To determine if these environments help clients and staff, Sivak assessed the behaviors of 14 mental health inpatients that used comfort rooms over a period of 4 months.
The clients were allowed to use the rooms for 30 minutes when they felt they needed them. The rooms, painted pastel green with chalkboard walls, had pleasing lighting, carpeting, comfortable chairs, televisions and movies for viewing. Items such as stress balls, puzzles, and drawing tools were also available upon request. Sivak found that after the comfort rooms were created, client-to-client assaults decreased by more than 23%, and assaults on staff members dropped by almost 50%. Most of the clients reported having a positive experience in the comfort rooms, and none needed antipsychotic or antianxiety medication immediately before or after being in the rooms. Since the addition of the comfort rooms, there has been no use of seclusion or restraints in that particular hospital. “Self-management empowers clients and promotes autonomy on their road to recovery,” said Sivak. She added, “Comfort rooms should be considered an important tool in the goal toward the reduction of seclusion and restraint use.”
Sivak, K. Implementation of Comfort Rooms to Reduce Seclusion, Restraint Use, and Acting-Out Behaviors. Journal of Psychosocial Nursing & Mental Health Services 50.2 (2012): 246-34. Print.
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