Dating physical restraint control
Use and abuse of restraints and seclusion are symptoms of poor quality of care, poor oversight, and misdirected public policy.Despite deep abhorrence of the long history of abuse of seclusion and restraint and the fact that these practices cause trauma even when used by well-meaning practitioners, MHA’s policy must also take into account exceptional circumstances in which restraints, in the least restrictive manner possible, may be required to avert imminent serious physical harm.Behavioral Health Treatment People are still being traumatized and dying from the use of seclusion and restraints.Lack of adequate staffing cannot justify the use of seclusion and restraints, and staffing may need to be increased to further this goal.Trauma-informed care and strict safeguards are also needed, to minimize trauma and harm.Unfortunately, despite this progress, there are still insufficient national standards governing how and when to use or avoid seclusion and restraints.Previous trauma is a strong contra-indication to any use of restraints and should be clearly noted to avoid further harm whenever possible.But this position statement is focused on use of restraints and seclusion in behavioral health treatment facilities.
It is my hope that we can create a single, unified policy – a set of primary principles that will govern how the Federal Government approaches the issue of seclusion and restraint for people with mental and addictive disorders.”10 Under Charles Curie’s leadership, continued under his successors, SAMHSA’s vision has been to reduce and ultimately eliminate seclusion and restraints from behavioral health treatment and rehabilitation facilities. ensur[ing] that, when such interventions are necessary, they are administered in as safe and humane a manner as possible by appropriately trained personnel.” This position was reiterated by NASMHPD executive director Bob Glover in 2005 when he wrote, “I believe that state facilities and other service providers must continue to make it a priority to reduce and ultimately eliminate these coercive practices in order to improve the quality of people’s lives.”11 NASMHPD led the way by passing the 1999 policy cited above, advocated change, and the states responded.
Few states make available aggregate data on the use of seclusion and restraints or even require the reporting and investigation of a death in a private or state psychiatric facility, and the federal government does not collect data on how many people are injured.