Manual restraint of adult psychiatric inpatients: a literature review

Abstract

Accessible summary Information about the use of manual restraint to manage violent or challenging behaviour in psychiatric hospitals is relatively scarce. This review includes 45 studies of manual restraint of adult psychiatric inpatients, mostly from the UK. Overall, the research suggests that manual restraint is used up to five times per month on an average ward, lasts for about 10 min and tends to involve patients being restrained face down on the floor. Manually restrained patients are young, male and detained under mental health legislation. We conclude that more and better‐quality research is needed to improve knowledge of how manual restraint is used in response to different types of incident and in different types of ward/hospital. Abstract Relatively little is known about the prevalence of manual restraint to manage violent or challenging behaviour in hospital psychiatric services or the circumstances of its use. This review identified 45 empirical studies of manual restraint of adult psychiatric inpatients, mostly from the UK. On average, up to five episodes per month of manual restraint might be expected on an average 20‐bed ward. Episodes last around 10 min, with about half involving the restraint of patients on the floor, usually in the prone position. Manually restrained patients tend to be younger, male and detained under mental health legislation. Staff value restraint‐related training, but its impact on nursing practice has not been evaluated. Research has tended to focus on official reports of violent incidents rather than manual restraint per se. Larger and more complex studies are needed to examine how manual restraint is used in response to different types of incident and in different service settings.

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