Use of Restraints and Seclusion on Children Can Be Dramatically Reduced

Rob Wipond
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The use of restraints and seclusion on children with “severe emotional disturbances” was reduced almost nine-fold after a staff training program in three New York psychiatric facilities, reported a study in Psychiatric Services.

“At facility one, the number of incidents per 1,000 client-days decreased from 67 to 25,” reported Psychiatric News. “At facility two, the decrease was from 63 to 7; and at facility three, the decrease was from 99 to 13.”

The activities that produced these outcomes included training in “ways to facilitate open, respectful two-way communication between management and staff and between staff and youth, and greater involvement of youth in program decision making.”

“The primary finding of this project was that the creation of coercion- and violence-free environments where use of restraint and seclusion is markedly decreased requires a major commitment by all staff over an extended period to fully understand and internalize the strategies involved and embrace the changes in facility culture,” the medical director of the New York State Office of Mental Health told Psychiatric News.

Wisdom, Jennifer P., David Wenger, David Robertson, Jayne Van Bramer, and Lloyd I. Sederer. “The New York State Office of Mental Health Positive Alternatives to Restraint and Seclusion (PARS) Project.” Psychiatric Services, May 1, 2015, appi.ps.201400279. doi:10.1176/appi.ps.201400279. (Abstract)

New York State Project Shows Progress in Reducing Use of Seclusion, Restraint for Children With Mental Illness (Psychiatric News Alert, May 4, 2015)

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Rob Wipond
Rob Wipond is a freelance journalist who writes frequently on the interfaces between psychiatry, civil rights, the justice system, and social change. His articles have been nominated for three Canadian National Magazine Awards, nine Western Magazine Awards, and five Webster Awards for journalism. He is currently working on a book about people's experiences of forced psychiatric treatment, and can be contacted through his website.

8 COMMENTS

  1. Oh no… all those dangerous children on the loose now? We’d better restrain those innocent infants and toddlers before they go on the rampage.

    Who are the emotionally disturbed ones here, the children being harmed, or the people who think that restraining children is a good thing?

    This infuriates me. Harm an adult, and I am upset. Harm a homeless person or an elderly person, and I am angry. Harm a child, and I am furious.

    Read that title again, slowly. Yes, you read it correctly: “Use of Restraints and Seclusion on Children Can Be Dramatically Reduced.”

    In the future will we be reading titles like: “Use of torture and abuse can be dramatically reduced”? or “Use of forcible sedation and isolation can be dramatically reduced”?

    Give me a break. Slay the Dragon of Psychiatry

    • I’m just wondering: if the training is enough to reduce the restraints like 9times does that mean that before that the staff was basically assaulting the kids due to incompetence? And if I did the same, like say keep punching people who make me angry in the face – would I also get away with “training” and get a prize for only punching 1 of 9 people going forward? I’d love to have the same standards applied to me since there are some psychiatrists that I’d like to apply some therapeutic physical contact to…

      “Who are the emotionally disturbed ones here, the children being harmed, or the people who think that restraining children is a good thing? ”
      Exactly…

    • Oh yes. They use what’s called a 5-point restraint where the person is put on a flat bed and then strapped down at each ankle and each wrist and at the waist. If they don’t quiet down they often get what’s called a “10-2” shot which is a mixture of a benzo and Haldol. Ex-patients and survivors often refer to this as needle rape. However, what’s become popular today is something called the “restraint chair”. It’s the same chair that is used in jails to control unruly people. And if you have trauma issues getting grabbed by a bunch of people and strapped down or into anything immediately triggers the experiencing of the original trauma all over again. Talk about feeling vulnerable and lacking any control over what happens to you. Imagine what this does to people who were sexually abused as children? It’s really awful.

      • They also sometimes physically hold them down and sit on their back or legs and hold their arms behind their backs until they calm down. I was trained in this technique when I was doing day treatment for 6-12 year old kids. Another intervention is locking them in a padded 4×4 foot room with a tiny window for extended periods. We were not allowed to use this for more than 5 minutes and had to check on them every minute, but I know there are many places that don’t follow these protocols.

        —- Steve

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