title: Unlocking an acute psychiatric ward: the impact on unauthorised absences, assaults and seclusions.
abstract: Aims and methodThe acute psychiatric in-patient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse event data before and after ward configuration change.ResultsRates of unauthorised absences increased by 58% after the change in ward configuration (P= 0.005), but seclusion hours dropped by 53% (P= 0.001). A small increase in violent incidents was recorded but this was not statistically significant.Clinical implicationsAlthough unauthorised absences increased, the absence of statistically significant changes for violent incidents and a reduction in seclusion hours suggest that the change to a less restrictive environment may have some positive effects.
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Ben
authors.initials: B
authors.lastname: Beaglehole
authors.affiliation: Canterbury District Health Board, Christchurch, New Zealand.
authors.forename: John
authors.initials: J
authors.lastname: Beveridge
authors.affiliation: Canterbury District Health Board, Christchurch, New Zealand.
authors.forename: Warren
authors.initials: W
authors.lastname: Campbell-Trotter
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Chris
authors.initials: C
authors.lastname: Frampton