Use of Seclusion and Restraint in Public Psychiatric Hospitals: Patient Characteristics and Facility Effects

Bruce B. Way · Steven M. Banks

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Abstract

Use of seclusion and restraint in 23 adult public psychiatric hospitals in New York State was examined by comparing demographic and diagnostic characteristics of 657 patients who were secluded or restrained during a four-week period with characteristics of 22,939 patients who were not. Logit analysis was used to calculate the probability of seclusion and restraint of individual patients with various combinations of characteristics. Characteristics associated with high probabilities included age less than 26 years, length of stay from 30 to 365 days, involuntary legal status, female gender, a diagnosis of mental retardation, and residence in a hospital with a high rate of seclusion and restraint. The rate of seclusion and restrain in the 23 hospitals ranged from .4 to 9.4 percent of patients. Both patient characteristics and the hospital of residence were needed to explain the case-by-case probability of a patient's being secluded or restrained.

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References

1950Ecological Correlations and the Behavior of Individuals 1965COMPREHENSIVE PSYCHIATRY 1978Observations on the theoretical bases for seclusion of the psychiatric inpatient 1986Characteristics of Psychiatric Patients Who Engage in Assaultive or Other Fear-Inducing Behaviors 1976IMPACT OF THE SECLUSION ROOM EXPERIENCE 1981Patterns of Seclusion 1978TOWARD A RATIONALE FOR THE SECLUSION PROCESS 1978Seclusion: uses and complications

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2003Two-Year Trends in the Use of Seclusion and Restraint Among Psychiatrically Hospitalized Youths 2000Coercion and restrictions in psychiatric inpatient treatment 2002ETHICS AND PRAXIS: ALTERNATIVE STRATEGIES TO PHYSICAL RESTRAINT AND SECLUSION IN A PSYCHIATRIC SETTING 2003Staff's attitudes to the use of restraint and seclusion in a Norwegian university psychiatric hospital 2000Emergency Psychiatry: Physical and Chemical Restraint in the Psychiatric Emergency Service 2007

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