Multinational Experiences in Reducing and Preventing the Use of Restraint and Seclusion

Restraint and seclusion (R/S) have been used in many countries and across service sectors for centuries. With the recent and increasing recognition of the harm associated with these procedures, efforts have been made to reduce and prevent R/S. Following a scathing media exposé in 1998 and congressional scrutiny, the United States began a national effort to reduce and prevent R/S use. With federal impetus and funding, an evidence-based practice, the Six Core Strategies1 to Prevent Conflict, Violence and the Use of Seclusion and Restraint, was developed. This model was widely and successfully implemented in a number of U.S. states and is being adopted by other countries, including Finland, Australia, and the United Kingdom. Recently, the first cluster randomized controlled study of the Six Core Strategies in Finland provided the first evidence-based data of the safety and effectiveness of a coercion prevention methodology. Preliminary findings of some of the international efforts are discussed. Reduction in R/S use and other positive outcomes are also reported

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

International planning directions for provision of mental health services

Internationally, there have been calls for more strategic mental health care delivery. For this to occur, individual countries need to define 'core' mental health services and set evidence-based, country-specific resource targets related to these. Via a web search, we identified 32 current mental health plans from five developed countries. We synthesised descriptive information from these documents, in order to compare profiles of 'core' services, resource targets relating to these services, and rationales for these resource targets. Most plans list 'core' clinical services, typically including a mix of inpatient and community services. Only four plans cite resource targets for these 'core' services, and these are difficult to compare due to different definitional and counting rules. All four provide rationales for the targets, though these vary in strength. The challenge remains for individual countries to develop plans that include appropriate resource targets, and to implement initiatives that move them towards these targets