Ann Nurs Primary Care | Volume 1, Issue 2 | Research Article | Open Access

Resilience of Patients in Mental Health Care and the Engagement Model: A Mixed Methods Evaluation

Sitvast J1*, Brummel J2 and Noorthoorn EO2

1University of Applied Sciences, Hogeschool Utrecht, Netherlands
2Mental Health Organization, Netherlands

*Correspondance to: Jan Sitvast 

Fulltext PDF


This article aims at reporting on how the Engagement Model has been implemented on 9 acute wards of a mental health care hospital and how this contributed to a reduction of rates of seclusion and restraint. We adopted the format of a case report based on reflections from the researcher (author) involved as agent in the implementation process. Secondly, coercive measures were rated using the Argus rating scale. This scale is used nationwide in the Netherlands. It covers seclusion, restraint and enforced medication. The steps are described that were taken to arrive at a consensus document that listed 12 core factors which then were translated in concrete interventions. A scoring instrument, EMOPI (Engagement Model Oriented Practice Inventory), was devised that was used to monitor the implementation process of these interventions. This monitoring showed that implementation during the first 6 months focused on basic aspects as hospitality and transparency of information giving and those other, more expertise-informed interventions as for instance trauma-informed treatment were held at bay. The assessment of data on restraint and seclusion showed that from 2010 until 2013 a reduction was achieved in rates of number of applied measures of seclusion and restraint and that also the duration of these measures has been reduced. However, rates were increasing again after 2013. This is probably caused by the end of the project and diminished focus due to organizational factors.


Seclusion and restraint; Engagement; Mental health nursing; Resilience; Implementation evaluation


Sitvast J, Brummel J, Noorthoorn EO. Resilience of Patients in Mental Health Care and the Engagement Model: A Mixed Methods Evaluation. Ann Nurs Primary Care. 2018; 1(2): 1011.

Subscribe to Our Newsletter