Benchmarking amongst forensic mental health services: A strategy to progress the movement toward elimination of restrictive practices

Ms Tessa Maguire1,2, Ms  Jo  Ryan1,2, Professor Brian McKenna2,3
1Forensicare, Melbourne, Australia, 2Centre for Forensic Behavioural Science/Swinburne University of Technology, Melbourne, Australia, 3Auckland University of Technology, Auckland, New Zealand

Restrictive practices are not therapeutic and application can lead to adverse outcomes. An evidence-base toward the elimination of the use of restrictive practices is provided by the Six Core Strategies. One of the Six Core Strategies is the use of data to drive practice change. Service data can be used to benchmark progress toward elimination of restrictive practices with other services. In Victoria all area mental health services benchmark against each other. However, research suggests there are distinct differences in rates, duration and multiple use of restrictive interventions in the state-wide forensic mental health service in Victoria, when compared to area mental health services. This indicates the need for specific forensic mental health benchmarks for the use of restrictive practices. However, there is not sufficient evidence to identify what the benchmarks should be for forensic mental health services (FMHS). This presentation discusses a research project that aimed to develop benchmarks to assist FMHS to reduce the use of restrictive interventions (for seclusion, physical restraint and mechanical restraint) across the states and territories of Australia, and the five regional services in New Zealand. A Delphi method research design was used to gain consensus on benchmarks among the Delphi members. Findings from this study suggest there are distinct differences among FMHS in regards to policy and practice. Delphi members reached agreement for suitable benchmarks for seclusion and physical restraint, which will be presented. These benchmarks will be used as a starting point for forensic services to begin benchmarking together to continue to work toward the elimination of restrictive practices.


Tessa Maguire is a Clinical Nurse Consultant at Forensicare and an Adjunct Lecturer in Forensic Mental Health Nursing at the Centre for Forensic Behavioural Science. Tessa is currently a PhD candidate and her research is investigating risk assessment and nursing interventions to reduce inpatient aggression and the use of restrictive practices.


TERP focuses on identifying, avoiding and reducing harm across all environments in which the care of people with mental ill health is provided. TERP inforces Australia’s commitment to reduce the use of, and eliminate restrictive practices as a priority for action. Each jurisdiction, in conjunction with the Safety and Quality Partnership Standing Committee and the Commonwealth Government, works towards this vision by holding a series of forums providing an opportunity to learn and grow from local and national initiatives to eliminate restrictive practices and create a dialogue for future care.

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