First paragraph: Even the most effective prediction techniques will not prevent all aggression in mental health care settings and when deescalation alone (see preceding chapter) is ineffective, staff will make the judgment to move toward more intrusive techniques, alongside continued deescalation, to coerce and ultimately control the patient. Such coercive and physical control is fraught with ethical, moral, and legal dilemmas and can be a potent cause of physical injury and psychological harm in both patients and staff. Once the decision to "up the stakes" has been taken, it is difficult to go back down the ladder of coercive interventions and there is a real risk that incompetent coercion can exacerbate the situation and be highly dangerous to the patient. In this chapter we will consider three things. Firstly, we will examine some of the difficult conceptual, ethical, and legal issues around the use of coercive measures in psychiatry. Secondly we will summarize some key, best practice, guidelines with regard to special observation, physical restraint, and seclusion with reference to the relevant sections of the UK National Institute for Clinical and Health Excellence (NICE) Clinical Practice Guidelines for the management of imminent violence. These guidelines are based on one of the most extensive and thorough appraisals of existing research on this issue. Thirdly, since this is a rapidly evolving area, we will examine recent research emerging in the past two to three years which was not included in the NICE review. Special attention will be paid in this section to two high priority questions: What is the service user perspective on the causes of conflict resulting in coercive measures and the actual experience of undergoing them? And, how can mental health services around the world act to reduce their reliance on seclusion and restraint and develop alternative, less coercive interventions
SummaryThe emergence of a drive to reduce restrictive interventions has been accompanied particularly in the UK by a debate focussing on restraint positions. Any restraint intervention delivered poorly can potentially lead to serious negative outcomes. More research is required to reliably state the risk attached to a particular position in a particular clinical circumstance.Declaration of interestF.S. is a consultant psychiatrist in Psychiatric Intensive Care at the Maudsley Hospital, London. He is on the Executive Committee of the National Association of Psychiatric Intensive Care and Low Secure Units, and was a member of the National Institute for Health and Care Excellence Guideline Development Group for the Short-Term Management of Aggression and Violence (2015). J.P. is a senior lecturer at the Faculty of Health and Life Sciences, Coventry University. E.B. is a consultant and expert witness in violence reduction and the use of physical interventions, independent expert to the High Secure Hospitals Violence Reduction Manual Steering Group and a member of the College of Policing Guideline Committee Steering Group and Mental Health Restraint Expert Reference Group. B.P. is the clinical director for Crisis and Aggression Limitation and Management (CALM) Training and formerly a senior lecturer for the Faculty of Health, University of Stirling. He is a nurse and psychotherapist and presently chairs the European Network for Training in the Management of Aggression. A.O'B. is a consultant psychiatrist, the Director of Educational Programmes for the National Association of Psychiatric Intensive Care and Low Secure Units, and the Dean for Students at St George's University of London.
Officer safety is crucial to police training yet in many areas it isfar from satisfactory and leaves officers exposed to the many dangers associated with modem-day policing. This article examines some of the most important components of officer safety and explains why officers are being placed at risk by a lack of coordination and poor methods of training. It also sets out the law relating to the use offorce.
No abstract
This chapter sets out the remedies available to the buyer under a contract of sale. Before the Sale and Supply of Goods to Consumers Regulations 2002, these remedies comprised damages for non-delivery of the contract goods, specific performance, and damages for breach of warranty. In cases of breach of condition, the buyer generally has the right to reject the goods and repudiate the contract. Since implementation of the 2002 Regulations, a buyer who deals as consumer has additional remedies of repair, replacement, reduction in price, or rescission. These additional consumer remedies are discussed after a consideration of the remedies that are available to all buyers, including consumers, beginning with those remedies granted to a buyer where the seller fails to deliver the goods, or fails to deliver on time. Certain consumer contracts entered into after 1 October 2015 are governed by the Consumer Rights Act 2015, which is also discussed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.