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

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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.

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Authors and Affiliations

  1. Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, WV, 26506, USA

    Michael Hendryx PhD

  2. Information Technology Department, Eastern State Hospital, PO Box 800, Medical Lake, WA, 99022, USA

    Yaroslav Trusevich MSW

  3. Eastern State Hospital, PO Box 800, Medical Lake, WA, 99020, USA

    Frank Coyle RN

  4. Washington Institute for Mental Illness Research and Training, Washington State University Spokane, 310 N. Riverpoint Blvd., PO Box 1495, Spokane, WA, 99210, USA

    Robert Short PhD

  5. College of Nursing, Washington State University Spokane, 310 N. Riverpoint Blvd., PO Box 1495, Spokane, WA, 99210, USA

    John Roll PhD

Authors
  1. Michael Hendryx PhD
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  2. Yaroslav Trusevich MSW
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  3. Frank Coyle RN
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  4. Robert Short PhD
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  5. John Roll PhD
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Correspondence to Michael Hendryx PhD.

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Hendryx, M., Trusevich, Y., Coyle, F. et al. The Distribution and Frequency of Seclusion and/or Restraint among Psychiatric Inpatients. J Behav Health Serv Res 37, 272–281 (2010). https://doi.org/10.1007/s11414-009-9191-1

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  • DOI: https://doi.org/10.1007/s11414-009-9191-1

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