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However, these reviews are not a routine feature of everyday acute care provision, and have historically been influenced by practices that reflect a managerial or disciplinary focus. A retrospective before\u2010and\u2010after study was conducted in an adult acute mental health inpatient unit in regional New South Wales, Australia. The goal was to determine the impact of strengths\u2010based restrictive practice review meetings from January 2019 to March 2020, with an equivalent timeframe before its implementation (October 2017\u2013December 2018). The events of seclusion, physical restraint, and Code Blacks (emergency codes requiring security personnel in response to personal safety threats) were compared before and after the implementation of review meetings, with covariate balancing applied to enhance comparability. The reduction in the rate of seclusion was statistically significant post\u2010implementation (incidence rate ratios [IRR]\u2009=\u20090.37, 95% CI [0.24, 0.57], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). At the same time, physical restraint showed a statistically insignificant reduction (IRR\u2009=\u20090.76, 95% CI [0.53, 1.09], <jats:italic>p<\/jats:italic>\u2009=\u20090.14). Code Black incidents remained stable (IRR\u2009=\u20091.02, 95% CI [0.70, 1.49], <jats:italic>p<\/jats:italic>\u2009=\u20090.91). These mixed results indicate that strengths\u2010based reviews play a role in reducing coercion, although additional strategies may be needed to achieve significant reductions in restrictive practice outcomes. Intervention development requires broader service\u2010level changes, with open and robust evaluations that enhance accountability and capture key influencing factors.<\/jats:p>","DOI":"10.1111\/inm.70059","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T13:36:55Z","timestamp":1748353015000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Outcomes of Restrictive Practice Review Meetings in an Acute Mental Health Unit: A Retrospective Before\u2010and\u2010After Study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3319-7077","authenticated-orcid":false,"given":"Esario IV","family":"Daguman","sequence":"first","affiliation":[{"name":"Faculty of Health, Southern Cross University  Coffs Harbour New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8544-1878","authenticated-orcid":false,"given":"Alison","family":"Taylor","sequence":"additional","affiliation":[{"name":"Integrated Mental Health, Alcohol and Other Drugs Coffs Harbour Base Hospital  Coffs Harbour New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1418-0864","authenticated-orcid":false,"given":"Matthew","family":"Flowers","sequence":"additional","affiliation":[{"name":"Integrated Mental Health, Alcohol and Other Drugs Coffs Harbour Base Hospital  Coffs Harbour 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":"Faculty of Health, Southern Cross University  Coffs Harbour 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":"Faculty of Health, Southern Cross University  Coffs Harbour New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"AIHW.2024.\u201cSeclusion and Restraint \u2013 Mental Health \u2013 AIHW.\u201d Australian Institute of Health and Welfare.https:\/\/www.aihw.gov.au\/mental\u2010health\/topic\u2010areas\/seclusion\u2010and\u2010restraint."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1078390318817130"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2008.59.10.1198"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3310\/hsdr09050"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12060628"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2024.111338"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2015.05.001"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447\u20100349.2011.00756.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13033\u2010016\u20100038\u2010x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1108\/IJWHM\u201001\u20102022\u20100013"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781139013567"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781446279267"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010020\u201001089\u20106"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13376"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17727"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40737\u2010024\u201000442\u2010y"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/sah0000628"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12890"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12762"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00131746-200301000-00003"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12380"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.colegn.2022.05.001"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600314"},{"issue":"3","key":"e_1_2_11_25_1","first-page":"126","article-title":"A Methodology for Conducting Retrospective Chart Review Research in Child and Adolescent Psychiatry","volume":"15","author":"Gearing R. 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