title: Recovery-based services in a psychiatric intensive care unit - the consumer perspective.
abstract: OBJECTIVE
  To describe the implementation of recovery-based practice into a psychiatric intensive care unit, and report change in seclusion rates over the period when these changes were introduced (2011-2013).
  
  
  METHODS
  Recovery-based practices including collaborative care, safety care plans, a comfort room, and debriefing after coercive interventions were introduced. A carer consultant was employed. A restraint and seclusion review committee, chaired by a peer worker, was established. A consumer exit interview was introduced and these data were collected, reviewed by staff and the peer worker and used to improve the ward environment. Rates of seclusion were measured during the period when recovery-based practices were introduced.
  
  
  RESULTS
  Consumer feedback indicated that positive aspects of the psychiatric intensive care unit included approachable, helpful staff and completion of a safety care plan. Negative aspects included lack of involvement in decisions about admission and about medications, the non-smoking policy, and being placed in seclusion or restraint. There was a significant reduction in the number of consumers secluded and the total number of seclusions.
  
  
  CONCLUSIONS
  Recovery principles can be successfully introduced in a psychiatric intensive care unit environment. Introduction of recovery based practice was associated with a reduction in seclusion.
authors.affiliation: Clinical Associate Professor, Clinical Lead, Central Adelaide Local Health Network, Adelaide, SA, and; The University of Adelaide, Adelaide, SA, Australia David.Ash@healh.sa.gov.au.
authors.forename: David
authors.initials: D
authors.lastname: Ash
authors.affiliation: Psychiatry Registrar, Clinical Lecturer, Central Adelaide Local Health Network, Adelaide, SA, and; The University of Adelaide, Adelaide, SA, Australia.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Suetani
authors.affiliation: Consultant Psychiatrist, Lyell McEwin Hospital, Elizabeth Vale, SA, and; Northern Adelaide Local Health Network, Adelaide, SA, Australia.
authors.forename: Jayakrishnan
authors.initials: J
authors.lastname: Nair
authors.affiliation: Coordinator Lived Experience Workforce, Central Adelaide Local Health Network, Adelaide, SA, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Halpin
mesh_terms: D000328:Adult; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care; D010356:Patient Isolation
keywords: consumer; psychiatric intensive care; psychiatric services; recovery; seclusion