Preventing Restraint and Seclusion

Multinational experiences in reducing and preventing the use of restraint and seclusion.

Restraint and seclusion (R/S) have been used in many countries and across service sectors for centuries. With the recent and increasing recognition of the harm associated with these procedures, efforts have been made to reduce and prevent R/S. Following a scathing media exposé in 1998 and congressional scrutiny, the United States began a national effort to reduce and prevent R/S use. With feder...

Regulatory, clinical, and educational approaches to eliminating restraint and seclusion

Background In response to national media attention on restraint and seclusion (R/S), state and national efforts in the USA have organized around the goal of eliminating their use. Several states/organizations have significantly reduced and stopped using these violent procedures. Participants will learn: 1) How some states/organizations changed treatment practice to prevent inpatient violence, 2...

The need to develop alternative measures to seclusion and restraint

In studies of psychiatric inpatients, the incidence of seclusion or restraint (S/R) varies widely (0-66%). Frequent use has been associated with e.g. violent behavior, age, sex, psychiatric symptoms and diagnosis of the patient, but also with the ward culture. The use of S/R is problematic since no randomized controlled studies of the safety or effectiveness of them were published. S/R may save...

SAMHSA's commitment to eliminating the use of seclusion and restraint.

Perspective on the Use of Seclusion and Restraint

Dr Zun has done an excellent job of reviewing the many controversies and complexities that surround the use of mechanical and chemical restraint as well as seclusion. He also shows us how many unanswered questions there are about such interventions. For example, an insightful psychiatric resident once raised the question of which intervention was more restrictive and stigmatizing: seclusion or ...