Reducing restraint in New York

Restraint and seclusion are 'last-resort' tactics that are used when a psychiatric patient presents an imminent risk to either themselves or others. They can cause emotional trauma, physical harm to patients or staff and even death as well as exposing hospitals to litigation and criminal prosecution. Researchers in New York looked at three different interventions aimed at reducing the use of restraint and seclusion. These were : decreasing the initial amount of time patients spent in restraint or seclusion, education of staff concerning identification of patients at risk of restraint or seclusion and early interventions to avoid crises and the use of coping questionnaires to assess patient preferences for dealing with agitation. After more than five years of the new policies the number of patients restrained was reduced, the hours of restraint fell, the number of patients secluded 'decreased significantly' and the mean hours of seclusion 'decreased markedly'. There were also significant decreases in patients absconding, fights and assaults.

Hellerstein, David J. – Decreasing the use of restraint and seclusion among psychiatric inpatients Journal of Psychiatric Practice September 2007, 13(5), 308-317