Restrictive Measures: Part 1

I’ve been slowly adding to a topic about community crisis and the use of restrictive measures. It seems to be a very controversial topic to discuss or mention. However, the alternative is not mentioning it and using more trauma-inducing methods of intervention. I feel like I have way too many questions to be addressed in just one post. So this will be an ongoing series of posts and fact-finding interviews with community leaders.

My biggest questions in this topic are: Why more community crisis agencies don’t apply for the state approval to use R.M.s? Why agencies are hand selecting specific clients while others are forwarded to hospitals or institutions? Do these agencies use the police as their crisis intervention technique?

The requirements and approval process for using restrictive measures are located in the following statutes and codes. WI statutes: 50.02(2), 51.61(1), 51.61(1i) and administrative codes: HFS 83.21 (4n), 94.10  Restrictive measures should be considered the method of last resort. The preceding methods include behavioral supports such as crisis intervention or de-escalation.

I started my experience with restrictive measures during a graduate school internship. Working with youth that had aggressive behaviors that warranted behavioral supports and R.M.s. Restrictive measures were built into their behavior intervention plans with prior approval for using specific measures. Most often, any physical contact with a client would be defensive, such as blocking a punch or holding their arms so they couldn’t injure themselves or others while they were verbally calmed down.

The state’s long-term care department made accusations about the agency using too many R.M.s with clients and I was able to review their documentation and prove that their use of R.M.s was drastically below what had been assumed. One reason for that is because they employed amazing people that knew how to build a trusting relationship with clients.

After ending my internship and going out into the surrounding communities to find employment, I discovered that while trauma-informed care was the hot new issue in research and training; other agencies that handled crisis and mental health were not using behavioral supports or crisis interventions in the same way as my internship agency. In fact, I found this local, state, and national epidemic of agency professionals using the police to intervene in crisis situations.

My first contact was Bret Loescher at DHS who is a Restrictive Measures Policy Manager. Both email and phone conversations.

Stay tuned for Part 2.