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The Distribution and Frequency of Seclusion and/or Restraint among Psychiatric Inpatients

  • Michael HendryxEmail author
  • Yaroslav Trusevich
  • Frank Coyle
  • Robert Short
  • John Roll
Article

Abstract

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.

Keywords

Seclusion Restraint Psychiatric Inpatients 

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Copyright information

© National Council for Community Behavioral Healthcare 2009

Authors and Affiliations

  • Michael Hendryx
    • 1
    Email author
  • Yaroslav Trusevich
    • 2
  • Frank Coyle
    • 3
  • Robert Short
    • 4
  • John Roll
    • 5
  1. 1.Department of Community MedicineWest Virginia UniversityMorgantownUSA
  2. 2.Information Technology DepartmentEastern State HospitalMedical LakeUSA
  3. 3.Eastern State HospitalMedical LakeUSA
  4. 4.Washington Institute for Mental Illness Research and TrainingWashington State University SpokaneSpokaneUSA
  5. 5.College of NursingWashington State University SpokaneSpokaneUSA

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