Effects of implementing a comfort room in an acute mental health unit on seclusion rates and client’s level of distress.

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Comfort rooms are specialised rooms, often within an inpatient psychiatric unit, which have a range of comforting materials and resources in them to assist an individual who is distressed to relax and perform “self-soothing” routines (e.g., relaxation exercises, self-massage, use of weighted blankets / comfort wraps) Previous investigations have demonstrated the utility of comfort rooms in reducing levels of distress in clients and also in reducing the use of seclusion and restraint. The aim of this project is to evaluate the effectiveness of the introduction of a comfort room into and acute inpatient mental health unit. Outcomes will be measured by a number of indicators: (1) rate of utilisation of the comfort room; (2) average length of time individuals remain in the comfort room; (3) behaviours observed before and after use of the comfort room; (4) what resources were used by the individual whilst in the comfort room; and (5) rates of seclusion before and after the introduction of the comfort room. Additionally, clients will be asked to report their subjective level of distress before and after using the room. This will be done by way of two simple questions asked by a member of nursing staff following the client leaving the comfort room: “Before you went into the comfort room, how distressed were you feeling on a scale of 1 to 10” and “Now, how distressed are you feeling, on a scale of 1 to 10”. Asking clients to rate their level of distress prior to using the comfort room is considered inappropriate, as any such delay in accessing the comfort room is not in keeping with the philosophy of quick and early access to the comfort room to promote best self-management of distress. It is hypothesised that the introduction of the comfort room will reduce distress experienced by clients by providing a comfortable environment and resources to self-sooth and de-stress. This hypothesis will be tested in the following ways: (1) Does the use of the comfort room reduce the level of self-reported distress experienced by clients? (2) Are fewer disruptive / disturbed behaviours noted in clients following the use of the comfort room? (3) Do rates of seclusion reduce following the introduction of the comfort room? The potential significance of this study is large. Similar projects are readily implementable (with limited capital outlay) in a range of settings across Australia and the results of this study have the potential to inform and change clinical practice in inpatient psychiatric units, leading to better outcomes for a large number of individuals across Australia. The results of this study will also add to the developing knowledge base around interventions designed to reduce the use of seclusion in Australian psychiatric inpatient units.

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