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Existing published literature needs to offer more high\u2010level guidance on the effectiveness of these service changes and their associated implementation factors. As a result, an overview of systematic reviews was undertaken to identify (i) nonpharmacological interventions to reduce conflict, aggression and restrictive practices in acute mental health settings, and (ii) their effects across different clinical outcomes. A parallel re\u2010extraction from primary studies was then utilised (iii) to identify factors influencing successful intervention implementation. Of 124 articles sourced from nine databases and registries, four reviews were retained for the final analysis, using the direction of effect and tabular and narrative summaries. These reviews included programmes or interventions focused on inpatient adolescent, adult and older adult populations. They reported on alternative containment strategies, risk assessments, Safewards, sensory rooms and equipment, Six Core Strategy\u2013based interventions and staff training. The overview found that a combination of interventions intended to improve relationships and reduce interpersonal conflict may help reduce aggression, conflict and restrictive practices. At the same time, stand\u2010alone staff training and sensory rooms and equipment may have mixed effects. The quality of the evidence linking these interventions to reductions in aggression, conflict and restrictive practices is limited. Successful implementation hinges on multiple factors: intervention characteristics, preparation and planning, evaluation and monitoring, outcome interpretation, stakeholder involvement\/investment, staff\u2010related factors and contextual factors. Any implementation initiative may benefit from using pragmatic and complexity\u2010informed research methodologies, including integrating meaningful involvement with service users, peer workers and culturally diverse groups.<\/jats:p>","DOI":"10.1111\/inm.13376","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T23:52:24Z","timestamp":1718668344000},"page":"1666-1686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Uncovering Complexities in Reducing Aggression, Conflict and Restrictive Practices in Acute Mental Healthcare Settings: An Overview of Reviews"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3319-7077","authenticated-orcid":false,"given":"Esario IV","family":"Daguman","sequence":"first","affiliation":[{"name":"Southern Cross University  Lismore New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0025-2681","authenticated-orcid":false,"given":"Marie","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Southern Cross University  Lismore New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4304-5431","authenticated-orcid":false,"given":"Richard","family":"Lakeman","sequence":"additional","affiliation":[{"name":"Southern Cross University  Lismore New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.045534"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010021\u201003304\u20100"},{"key":"e_1_2_12_4_1","volume-title":"Indigenous Health and Wellbeing","author":"AIHW","year":"2022"},{"key":"e_1_2_12_5_1","volume-title":"Seclusion and Restraint \u2013 Mental Health \u2013 AIHW","author":"AIHW","year":"2023"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488\u2010022\u201001242\u2010x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078390318817130"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/pts.0000000000000827"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/02793695\u201020180305\u201002"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"key":"e_1_2_12_11_1","volume-title":"The Epidemic of Dwangtoepassingen in de Psychiatrie","author":"Baars van A.","year":"2006"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744\u20106163.2011.00307.x"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3310\/hsdr09050"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/chso.12581"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1229"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2020.144"},{"key":"e_1_2_12_17_1","volume-title":"Abnormal Psychology (Canadian edition)","author":"Barlow D. 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