The Distribution and Frequency of Seclusion and/or Restraint among Psychiatric Inpatients
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This paper reports on the frequency and distribution of seclusion or restraint (SR) episodes among 1,266 adult inpatients at a state psychiatric hospital during the 2004 calendar year. Data on the concentration of SR episodes over patients and time can assist in planning alternative, recovery-oriented treatment models. Fifteen percent (N = 194) of patients experienced seclusion or restraint. Sixty-three percent of all seclusion hours were concentrated among only ten patients. Likewise, the ten patients with the most restraint hours constituted nearly 65% of total restraint hours for the year and 48% of all restraint episodes. Variables accessible through administrative data accounted for modest seclusion and restraint variance. A comprehensive strategy to prevent SR episodes requires tailored interventions targeted to known high-risk individuals and development of general hospital-wide alternatives to SR. General alternatives require greater attention to staff education, administrative oversight, de-escalation and debriefing practices, patient involvement, and other recovery-oriented practices to reduce or eliminate use of seclusion and restraint.
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- The Distribution and Frequency of Seclusion and/or Restraint among Psychiatric Inpatients
The Journal of Behavioral Health Services & Research
Volume 37, Issue 2 , pp 272-281
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- Springer US
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- 1. Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, WV, 26506, USA
- 2. Information Technology Department, Eastern State Hospital, PO Box 800, Medical Lake, WA, 99022, USA
- 3. Eastern State Hospital, PO Box 800, Medical Lake, WA, 99020, USA
- 4. Washington Institute for Mental Illness Research and Training, Washington State University Spokane, 310 N. Riverpoint Blvd., PO Box 1495, Spokane, WA, 99210, USA
- 5. College of Nursing, Washington State University Spokane, 310 N. Riverpoint Blvd., PO Box 1495, Spokane, WA, 99210, USA