Managing treatment resistant violent adolescents: a step forward by substituting seclusion for mechanical restraint?

Adm Policy Ment Health

Child and Adolescent Psychiatry, Dorothea Dix Hospital, 3601 MSC Center, Raleigh, NC 27699, USA.

Published: May 2008

AI Article Synopsis

  • There is a growing agreement that seclusion and restraint shouldn't be used on children and adolescents, but some still show persistent violent behavior.
  • A study aimed to evaluate whether having a padded seclusion room could reduce the need for mechanical restraints, which are often more traumatic.
  • After the padded room was implemented, incidents of mechanical restraints dropped dramatically by 93.7%, suggesting that this approach might be a safer, although still not ideal, option.

Article Abstract

Despite a growing consensus that seclusion or restraint should never be used with children or adolescents, there are a few patients who are resistant to treatment, and are persistently violent. The purpose of this study was to measure the efficacy of installing a padded seclusion room to decrease the use of mechanical restraints, a potentially more emotionally traumatic and dangerous intervention than seclusion. After padded room installation, the number of monthly mechanical restraint events per 1000 patient days decreased by 93.7%, from 21.2 to 1.3. A padded seclusion room may offer a safer, albeit a less than desirable alternative to mechanical restraint.

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Source
http://dx.doi.org/10.1007/s10488-007-0156-5DOI Listing

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Seclusion and restraint are frequent procedures to intervene in aggressive and potentially dangerous patients in psychiatric settings. However, little is known about their utilization and effectiveness in pediatric populations. We aimed to examine the prevalence and determinants of seclusion and restraint utilization in children and adolescents in psychiatric settings.

View Article and Find Full Text PDF
Article Synopsis
  • There is a growing agreement that seclusion and restraint shouldn't be used on children and adolescents, but some still show persistent violent behavior.
  • A study aimed to evaluate whether having a padded seclusion room could reduce the need for mechanical restraints, which are often more traumatic.
  • After the padded room was implemented, incidents of mechanical restraints dropped dramatically by 93.7%, suggesting that this approach might be a safer, although still not ideal, option.
View Article and Find Full Text PDF

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