Patients’ Perspective on Mechanical Restraints in Acute and Emergency Psychiatric Settings: A Poststructural Feminist Analysis

  • Jean Daniel JacobEmail author
  • Dave Holmes
  • Désiré Rioux
  • Pascale Corneau


Mechanical restraints are most often used in circumstances where behaviours are believed to be a threat to the welfare and safety of others or the individual him or herself. However, the degree to which health care professionals justify the uses of mechanical restraints in relation to the perceived beneficial effects expressed by those who must experience them may very well prove to be quite different. The overarching purpose of this chapter is to shed light on the lived experience of mechanically restrained patients hospitalized in psychiatric settings (acute psychiatric care unit and psychiatric emergency unit) in order to explore gendered power relations in psychiatric care. While this chapter focuses specifically on the experience of women who have been restrained, it would seem that mechanical restraints operate in a system where authority is embedded in psychiatric practices and likely to affect all who are in contact with this setting.


  1. Bourdieu, P. 1998. La Domination Masculine. Paris: Seuil.Google Scholar
  2. Brocki, J.M., and A.J. Wearden. 2006. A Critical Evaluation of the Use of Interpretative Phenomenological Analysis (IPA) in Health Psychology. Psychology & Health 21 (1): 87–108.CrossRefGoogle Scholar
  3. Canadian Institute for Health Information. 2011. Restraint Use and Other Control Interventions for Mental Health Inpatients in Ontario.
  4. Colaizzi, P.F. 1978. Psychological Research as the Phenomenologists Views It. In Existential Phenomenological Alternatives for Psychology, ed. R.S. Valle and M. King. New York: Oxford University Press.Google Scholar
  5. Duxbury, J. 2002. An Evaluation of Staff and Patient Views of Strategies Employed to Manage Inpatient Aggression and Violence on One Mental Health Unit: A Pluralistic Design. Journal of Psychiatric and Mental Health Nursing 9: 325–337.CrossRefGoogle Scholar
  6. Duxbury, J., and R. Whittington. 2005. Causes and Management of Patient Aggression and Violence: Staff and Patient Perspectives. Journal of Advanced Nursing 50 (5): 469–478.CrossRefGoogle Scholar
  7. Foucault, M. 1994. Histoire de la Sexualité: La Volonté de Savoir. St-Amand: Éditions Tel/Gallimard.Google Scholar
  8. ———. 1995. Discipline & Punish: The Birth of the Prison. New York: Vintage Books.Google Scholar
  9. Francis, B. 2000. Poststructuralism and Nursing: Uncomfortable Bedfellows? Nursing Inquiry 7: 20–28.CrossRefGoogle Scholar
  10. Goethals, S., B. Dierckx de Casterlé, and C. Gastmans. 2012. Nurses’ Decision-Making in Cases of Physical Restraint: A Synthesis of Qualitative Evidence. Journal of Advanced Nursing 68 (6): 1198–1210.CrossRefGoogle Scholar
  11. Goffman, E. 1990. Asylums. Essays on the Social Situation of Mental Patients and Other Inmates. New York: Anchor Books.Google Scholar
  12. Hall, A., B. McKenna, V. Dearie, T. Maguire, R. Charleston, and T. Furness. 2016. Educating Emergency Department Nurses About Trauma Informed Care for People Presenting with Mental Health Crisis: A Pilot Study. BMC Nursing 15: 21–29.CrossRefGoogle Scholar
  13. Heidegger, M. 1962. Being and Time. Trans. J. Macquarrie & E. Robinson. New York: Harper & Row.Google Scholar
  14. ———. 1971. Poetry, Language, Thought. Trans. A. Hofstadter. New York: Harper Collins.Google Scholar
  15. Holmes, D. 2005. Governing the Captives: Forensic Psychiatric Nursing in Corrections. Perspectives in Psychiatric Care 41 (1): 3–13.CrossRefGoogle Scholar
  16. Holmes, D., and D. Gastaldo. 2002. Nursing as Means of Governmentality. Journal of Advanced Nursing 38 (6): 557–565.CrossRefGoogle Scholar
  17. Holmes, D., D. Rioux, J.D. Jacob, and P. Corneau. 2016. Contention Physique: L’expérience des Patients. Santé Mentale 210: 64–71.Google Scholar
  18. Jacob, J.D. 2012. Working in a Violent Environment: The Pitfall of Integrating Security Imperatives into Forensic Psychiatric Nursing. In (Re)Thinking Violence in Health Care Settings: A Critical Approach, ed. D. Holmes, T. Rudge, and A. Perron, 315–330. Surrey: Ashgate.Google Scholar
  19. Jacob, J.D., M. Gagnon, A. Perron, and D. Holmes. 2009. Sovereign Power, Spectacle and the Deviant Body: The Use of the Seclusion Room in Psychiatric Nursing. International Journal of Culture and Mental Health 2 (2): 1–11.CrossRefGoogle Scholar
  20. Johnson, K., and E.F. Morrison. 1993. Control or Negotiation: A Healthcare Challenge. Nursing Administration Quarterly 17 (3): 27–33.CrossRefGoogle Scholar
  21. Larkin, M., S. Watts, and E. Clifton. 2006. Giving Voice and Making Sense in Interpretative Phenomenological Analysis. Qualitative Research in Psychology 3 (2): 102–120.CrossRefGoogle Scholar
  22. Lawoko, S., J.J.F. Soares, and P. Nolan. 2004. Violence Towards Psychiatric Staff: A Comparison of Gender, Job and Environmental Characteristics in England and Sweden. Work & Stress 18 (1): 39–55.CrossRefGoogle Scholar
  23. Leder, D. 1998. The absent body. Chicago: University of Chicago Press.Google Scholar
  24. Lehoux, P., G. Daudelin, B. Poland, G.J. Andrews, and D. Holmes. 2007. Designing a Better Place for Patients: Professional Struggles Surrounding Satellite and Mobile Dialysis Units. Social Science and Medicine 65: 1536–1548.CrossRefGoogle Scholar
  25. Malpas, J. 1998. Finding Place: Spatiality, Locality, and Subjectivity. In Philosophies of Place, ed. A. Light and J.M. Smith, 21–44. Lanham, MD: Rowman & Littlefield.Google Scholar
  26. McCormick, J.L. 1997. The Discourses of Control: Power in Nursing. PhD diss., University of British Columbia. Unpublished manuscript.Google Scholar
  27. McGrath, L., and P. Reavey. 2013. Heterotopias of Control: Placing the Material in Experiences of Mental Health Service Use and Community Living. Health & Place 22: 123–131.CrossRefGoogle Scholar
  28. Merleau-Ponty, M. 1962. Phenomenology of Perception. Trans. Colin Smith. London: Routledge & Kegan Paul.Google Scholar
  29. Morrall, P., and E. Muir-Cochrane. 2002. Naked Social Control: Seclusion and Psychiatric Nursing in Post-Liberal Society. Australian e-Journal for the Advancement of Mental Health 1 (2): 1–12.CrossRefGoogle Scholar
  30. Morrison, E.F. 1990. The Tradition of Toughness: A Study of Nonprofessional Nursing Care in Psychiatric Settings. Journal of Nursing Scholarship 22 (1): 32–38.CrossRefGoogle Scholar
  31. ———. 1998. The Culture of Caregiving and Aggression in a Psychiatric Setting. Archives of Psychiatric Nursing 12 (1): 21–31.CrossRefGoogle Scholar
  32. Muir-Cochrane, E., and A. Gerace. 2014. Containement Practices in Psychiatric Care. In Power and the Psychiatric Apparatus, ed. D. Holmes, J.D. Jacob, and A. Perron, 91–115. Surrey: Ashgate Publishing.Google Scholar
  33. Nancy, J.-L. 2009. Corpus. Trans. R.A. Rand. New York: Fordham University Press.Google Scholar
  34. Paterson, B., and J. Duxbury. 2007. Restraint and the Question of Validity. Nursing Ethics 14 (4): 535–545.CrossRefGoogle Scholar
  35. Reid, K., P. Flowers, and M. Larkin. 2005. Interpretative Phenomenological Analysis: An Overview and Methodological Review. The Psychologist 18: 20–23.Google Scholar
  36. Riahi, S., G. Thomson, and J. Duxbury. 2016. An Integrative Review Exploring Decision-Making Factors Influencing Mental Health Nurses in the Use of Restraint. Journal of Psychiatric and Mental Health Nursing 23: 116–128.CrossRefGoogle Scholar
  37. Schein, E.H. 2004. Organizational Culture and Leadership. 3rd ed. San Francisco: Jossey-Bass.Google Scholar
  38. Shildrick, M., and R. Mykitiuk, eds. 2005. Ethics of the Body: Postconventional Challenges. Cambridge, MA: MIT Press.Google Scholar
  39. Smith, J.A. 1996. Beyond the Divide Between Cognition and Discourse: Using Interpretative Phenomenological Analysis in Health Psychology. Psychology & Health 11 (2): 261–271.CrossRefGoogle Scholar
  40. ———. 2004. Reflecting on the Development of Interpretative Phenomenological Analysis and Its Contribution to Qualitative Research in Psychology. Qualitative Research in Psychology 1: 39–54.Google Scholar
  41. Smith, J.A., P. Flowers, and M. Larkin. 2009. Interpretive Phenomenological Analysis: Theory, Method and Research. London: Sage.Google Scholar
  42. Strout, T.D. 2010. Perspectives on the Experience of Being Physically Restrained: An Integrative Review of the Qualitative Literature. International Journal of Mental Health Nursing 19: 416–427.CrossRefGoogle Scholar
  43. Stuart, D., L. Bowers, A. Simpson, C. Ryan, and M. Tziggili. 2009. Manual Restraint of Adult Psychiatric Inpatients: A Literature Review. Journal of Psychiatric and Mental Health Nursing 16 (8): 749–757.CrossRefGoogle Scholar
  44. Varela, F.J. 1999. Ethical Know-How: Action, Wisdom, and Cognition. Stanford: Stanford University Press.Google Scholar
  45. Varela, F.J., E. Thompson, and E. Rosch. 1991. The Embodied Mind: Cognitive Science and Human Experience. Cambridge, MA: MIT Press.Google Scholar
  46. Weedon, C. 1997. Feminist Practice and Poststructuralist Theory. London: Blackwell.Google Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Jean Daniel Jacob
    • 1
    Email author
  • Dave Holmes
    • 1
  • Désiré Rioux
    • 1
  • Pascale Corneau
    • 1
  1. 1.University of OttawaOttawaCanada

Personalised recommendations