Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends

@article{Steinert2009IncidenceOS,
  title={Incidence of seclusion and restraint in psychiatric hospitals: a literature review and survey of international trends},
  author={Tilman Steinert and Peter Lepping and Renate Bernhardsgr{\"u}tter and Andreas Conca and Trond Hatling and Wim A Janssen and Alice Keski-Valkama and Ferm{\'i}n Mayoral and Richard Whittington},
  journal={Social Psychiatry and Psychiatric Epidemiology},
  year={2009},
  volume={45},
  pages={889-897}
}
ObjectiveThe aim of this study was to identify quantitative data on the use of seclusion and restraint in different countries and on initiatives to reduce these interventions.MethodsCombined literature review on initiatives to reduce seclusion and restraint, and epidemiological data on the frequency and means of use in the 21st century in different countries. Unpublished study was detected by contacting authors of conference presentations. Minimum requirements for the inclusion of data were… 
Prevalence and correlates of seclusion and restraint use in children and adolescents: a systematic review
TLDR
A systematic literature review of studies published in the last 10 years reporting on the prevalence and determinants of seclusion and restraint use in psychiatrically ill youth treated in psychiatric settings concluded that there is some indication that se inclusion and restraints can lead to severe psychological and physical consequences.
The Use of Physical Restraint in Norwegian Adult Psychiatric Hospitals
  • R. Wynn
  • Medicine, Psychology
    Psychiatry journal
  • 2015
TLDR
There are differences in use between wards and institutions, which in part may be explained by differences in patient populations, and staff appear to be less negative to the use of restraint than patients.
Use of Restraint and Seclusion in Psychiatric Settings: A Literature Review.
TLDR
The current analysis found that restraint and seclusion should be used as a last resort measure in daily nursing practice.
Effects of a Regulatory Protocol for Mechanical Restraint and Coercion in a Spanish Psychiatric Ward.
TLDR
If the introduction of a new regulatory protocol in a specific psychiatric ward in Andalusia (Spain) contributed to reducing the use of mechanical restraint, then being female and the year of restraint (2012) are associated with a shorter period of coercion.
Seclusion versus mechanical restraint in psychiatry – a systematic review
TLDR
It cannot be determined whether seclusion is superior to mechanical restraint or vice versa, and the availability of both methods seems necessary – as both have their pros and cons.
The scope for replacing seclusion with time out in acute inpatient psychiatry in England.
TLDR
There is good evidence that seclusion rates can be reduced safely, and time out can sometimes be used as a substitute, and a national registration and reporting system should be introduced in England.
Who are the restrained and secluded patients: a 15-year nationwide study
TLDR
The age profile of the restrained/secluded patients was unstable over time and the risk of being restrained/ seclusion was not associated with gender, and remained constant over time.
Trends in the use of coercive measures in Finnish psychiatric hospitals: a register analysis of the past two decades
TLDR
Despite the decreasing national level of coercive measures used in Finnish psychiatric hospitals, the overall reduction has been small during the last two decades, which has implications on the future development of structured guidelines and interventions for preventing and more effectively managing challenging situations.
Methodological issues in monitoring the use of coercive measures.
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References

SHOWING 1-10 OF 45 REFERENCES
A 15-year national follow-up: legislation is not enough to reduce the use of seclusion and restraint
TLDR
The total number of the secluded and restrained patients declined as did the number of all inpatients during the study weeks, but the risk of being secluded or restrained remained the same over time when compared to the first study year.
[The review of seclusion and restraint in psychiatric practice].
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    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica
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TLDR
Although the review system had the potential to slightly reduce the use of seclusion and restraint, and to increase patient satisfaction, staff burnout was risked because staff effort was perceived to be disproportionately high in relation to the effect achieved.
The use of seclusion in the Netherlands compared to countries in and outside Europe.
An analysis of successful efforts to reduce the use of seclusion and restraint at a public psychiatric hospital.
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  • Medicine, Psychology
    Psychiatric services
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TLDR
The results of this analysis underscore the importance of clinical and administrative priorities in efforts to reduce the use of seclusion and restraint in public psychiatric hospitals.
Restraint and seclusion: a review of the literature.
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  • Medicine
    The American journal of psychiatry
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TLDR
The literature on restraint and seclusion supports the following: 1) Seclusion and restraint are basically efficacious in preventing injury and reducing agitation, and 2) Training in prediction and prevention of violence, in self-defense, and in implementation of restraint and/or seclusion is valuable in reducing rates and untoward effects.
The use of mechanical restraint and seclusion in patients with schizophrenia: A comparison of the practice in Germany and Switzerland
TLDR
For future European research on the use of compulsory measures in routine psychiatric care, there is a need for uniformed definitions, reliable documentation of coercive measures as well as for an identical way of data analysis.
A Study of the Use of Seclusion in an Acute Psychiatric Service
TLDR
This study shows that seclusion is regularly practiced in the psychiatric wards of the Waikato area and in the majority of cases, its use was related to actual or threatened violence.
Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics
TLDR
The incidence and duration of coercive measures varied highly between different diagnostic groups and different hospitals, and use of detailed guidelines for seclusion and restraint was associated with a lower incidence of coercion measures.
SAMHSA's commitment to eliminating the use of seclusion and restraint.
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  • Medicine
    Psychiatric services
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TLDR
The rate and duration of seclusion and mechanical restraint decreased dramatically during this period and many factors contributed to the success of this effort, including advocacy efforts, state policy change, improved patient-staff ratios, response teams, and second-generation antipsychotics.
An updated national survey on seclusion and restraint.
A survey of the use of seclusion and restraint during 1994 was conducted at 124 state psychiatric hospitals to update data from a survey of 108 such hospitals conducted for 1991. Rates of patients'
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