Understanding Restrictive Practices in Adult Mental Health Inpatient Services: Use, Definition and Measurement

This thesis examines how reported rates of restrictive practices, such as seclusion, restraint, and other coercive measures vary across regions in adult mental health inpatient settings. It identifies potential sources of variability, demonstrating that inconsistent definitions, measurement methods, and reporting practices likely distort these rates beyond differences in frequency of use. It also highlights disparities in how clinicians, researchers, service users, and family caregivers interpret certain actions as restrictive practices or not. Findings support the development of standardized definitions, valid measurement approaches and consistent reporting systems internationally to generate reliable data, guiding policy and clinical practices for reducing restrictive practices.