The purpose of this study was to determine if physical restraint and/or seclusion had been used with different frequencies in patients of different racial groups in an inpatient forensic psychiatry facility. The method used was a retrospective correlational study of all inpatients (n = 806) treated from January 1993 through August 2000 at Kirby Forensic Psychiatric Center, a maximum-security in...

Aims and method The acute psychiatric in-patient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse ...

Rates of restraint and seclusion on a child and adolescent unit were evaluated before and after the implementation of a restrictive state law which was designed to reduce the monthly rates of restraint. Overall, the total number of hours in restraint, corrected for mean daily census, decreased significantly. The average number of patients in chemical restraint stayed about the same. There was a...

The medical community is becoming increasingly concerned about violent patients in healthcare settings. Healthcare professionals should be trained to deal with aggressive patients, and they should have access to a room free of dangerous objects for evaluation and examination. Having security personnel stand by may be appropriate in some cases. Verbal intervention is the key to dealing with viol...

The mental health field continues to be concerned about the use of seclusion and of mechanical and chemical restraints in treatment settings. Recovery Innovations, Inc. (RI), a nonprofit corporation that operates a range of recovery-oriented programs, successfully eliminated use of seclusion and nonchemical restraints in a crisis center. This success was the impetus behind implementation and ev...

Improving clinical outcomes, treating aggression, and reducing the use of restraints and seclusion are major concerns to providers of psychiatric services. Devising precise treatments directed by causal hypotheses that address the functional properties of maladaptive behaviors are essential for reducing aggression, increasing understanding of causal factors, and enhancing individual control and...

There are significant issues associated with the use of restrictive measures, such as seclusion and restraint, in child and adolescent mental health care. Greater understanding of how restrictive measures are used is important for informing strategies to reduce their use. In this brief report we present a 12-month audit (1/1/2010-31/12/2011) of the use of restrictive measures (seclusion, physic...

Efforts to reduce aggression and violence and the use of restraint and seclusion have traditionally been through some form of educational program. This paper presents an integrative review of research and quality improvement projects that aimed to reduce aggression/violence or restraint/seclusion through the use of an educational program. Forty-six papers are included in this review. This paper...

Mental health professionals worldwide realize the imperative for reducing inpatient restraints and seclusion. The high incidence of posttraumatic stress disorder for inpatients and the resulting symptoms support the creation of a trauma-informed approach. The objective of the current article is to describe the experience of staff in a 20-bed unit transitioning from traditional inpatient care to...

Seclusion and restraint are essential interventions in the acute psychiatric care of patients in correctional environments. When administered and monitored properly, they are safe and effective in reducing the risk of harm. However, correctional systems have not developed uniform practices that are consistent with current community standards. There has been no clear national standard of care fo...