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The greatest use of restraint and seclusion are made for non-violent behaviors in order to limit the progression of disruptive behavior to artual violence (Soloff et al 1988), but some patients produce alarm without risk, while others produce risk without alarm. The question is whose judgement of risk is to prevail? There is a substantial subjective element in the perception of dangerousness, w...

The management of aggression, violence and behavioural disturbance remains a challenging problem for psychiatric services despite advances in pharmacotherapy, psychological interventions for many mental disorders and improvement in the delivery of community psychiatric services. Notwithstanding the continuing trend of delivering psychiatric care in the community with the active input of patient...

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...