Use of Seclusion and Restraint in Public Psychiatric Hospitals: Patient Characteristics and Facility Effects

Psychiatric inpatients’ perceptions of positive and negative aspects of physical restraint

“…When considering the use of physical restraint, it is important that, as with other health care interventions, it only follows after an effective assessment of the patient's mental condition and after consideration of any suitable alternatives, such as showing more concern and empathy with the patient's mental condition and modifying the medication regimen. In short, the use of physical restraint should be based on the prevailing needs of the patient and should be used only as a last resort [21].…”

Ethics and Praxis: Alternative Strategies to Physical Restraint and Seclusion in a Psychiatric Setting

“…Strumpf and Tomes (1993) trace the historical and philosophica l controversy of restraining the mentally ill throughout the last 200 years. The literature is burgeoning with references as to the questionabl e ethics of restraining and secluding patients in healthcare settings (Blakeslee, Goldman, Papougenis, & Torell, 1991;Bower, 2000;Dawkins, 1998;Haddal, 1999;Hopton, 1995;Marangos-Frost & Wells, 2000;Mattiasson & Andersson, 1995;May, 1995;Moss & LaPuma, 1991;Strumpf & Evans, 1991), the therapeutic effectiveness (Cashin, 1996;Martinez, Grimm, & Adamson, 1999;Johnson, 1998), and the inherent dangers in these practices (Crenshaw & Francis, 1995;Maier, VanRybroek, & Mays, 1994;Miles & Irvine, 1992;Mohr, Mahon, & Noone, 1998;Patter, Leadbetter, & McComish, 1994;Way & Banks, 1990;Weiss, 1998). In addition to physical harm, restraint and seclusion can cause psychologica l harm and negative attitude toward treatment (Cashin, 1996;Dawkins, 1998;Martinez, Grimm, & Adamson, 1999;Sullivan-Marx, 1995).…”

Restraint and Seclusion in Services for People with Mental Health Problems and Learning Disabilities: A Literature Review

“…Large variations have been found in the use of seclusion and restraint (Way & Banks 1990); Alty & Mason (1994) cite figures showing between 2% and 66% of psychiatric inpatients experience one or both practices, and the characteristics of people who are restrained or secluded differ widely between studies (Swett 1994;Walsh & Randall 1995). Measuring in terms of number of incidents rather than number of people, Gudjonsson et al (2000) found that seclusion was the outcome of 4% of violent incidents; Shepherd & Lavender (1999) had a comparable figure of 1.6%.…”

“…Measuring in terms of number of incidents rather than number of people, Gudjonsson et al (2000) found that seclusion was the outcome of 4% of violent incidents; Shepherd & Lavender (1999) had a comparable figure of 1.6%. Way & Banks (1990) suggested that there was a 'facility effect' with the culture of the institution being the biggest factor in the use of these practices. Differences in practices of recording, legislative frameworks, interpretation of guidelines, type of institution and demographics of a patient population (e.g.…”