The Safewards Model and I.R.O.N. Interventions in a No-Restraint Ward

The psychiatry inpatient ward of Trento (SPDC: italian acronym for Servizio Psichiatrico di Diagnosi e Cura - i.e. Psychiatric Service for Diagnosis and Treatment) operates with an open-door policy, emphasising a recovery-oriented approach. The professionals are capable of adopting the patient's perspective as a "person" rather than seeing them as a "patient", allowing them the freedom and responsibility to make decisions about their own lives. The SPDC of Trento is a no-restraint psychiatric ward, where relational restraint is prioritised, and patients' responsibility is maximised, avoiding, where possible, the use of physical restraint. In 2022, our SPDC introduced the so-called I.R.O.N. interventions (Italian: Interventi Relazionali prolungati ad Orientamento No restraint - no-restraint-oriented relational interventions). These interventions are used in situations of patient agitation to ease tension and resolve crises by employing methods that are both "gentle" and "iron" at the same time, highlighting the determination, patience, and 'relational time' required from the work team. At the end of the intervention, the strategies implemented are described in a register and later shared with the work team. At the end of the year, individuals who have demonstrated their commitment to supporting their colleagues will be awarded an "IRON parchment". A special "Talk Down Champion" parchment will be awarded to the person who manages to consistently maintain this style of work, always in agreement with the team and the safety of all (operators and patients).