No abstract

This experience in reducing aggression within the hospital validates theory that suggests that violence within institutions is context-based, involving patients, staff, and the institutional climate. The authors believe that the outcomes support the proposition that the use of coercion is determined more by traditions of practice and the mindset of the staff than by clinical necessity, and that its use can be significantly reduced by organization interventions.

We hypothesize that the persistent use of coercive interventions in which staff have a low level of confidence reflect both the influence of tradition in the management of aggressive behavior and unacknowledged avoidant/coercive staff responses to patents labeled as deviant. Differences between the public and private sectors and between hospitals within each sector imply that the practice of seclusion and restraint may be idiosyncratic to each institution, and suggest the need for a generally accepted standard for their use.

The 1990s saw the enactment of much "get tough with young offenders" legislation in the United States. At the same, problems with our present punishment and treatment model, in which many youngsters cycle repeatedly through the justice and mental health systems, raised interest in restorative justice, a community-based alternative model emphasizing a balanced, negotiated approach to the needs of victims, offenders, and the community. After summarizing the philosophical bases underlying both models, this article describes the practice of restorative justice in New Zealand, where it was pioneered. Restorative justice has special relevance for Maori community in New Zealand and minority communities in the United States, where youth are consistently overrepresented in the courts, detention centers, and jails, and in which the juvenile justice system is seen as hostile and biased. Outcome data from New Zealand and early outcome research from the United States suggest that the restorative model, in which offenses are understood as a breakdown in social bonds, offers a hopeful alternative for offending youngsters, their families, and their communities.