Characteristics and correlates of seclusion and mechanical restraint measures in a Parisian psychiatric hospital group.

Journal: Frontiers in psychiatry

Volume: 15

Issue: 

Year of Publication: 

Affiliated Institutions:  Département d'information Medicale, GHU Paris Psychiatrie et Neurosciences, Paris, France. Cellule épidémiologie, GHU Paris Psychiatrie et Neurosciences, Paris, France. Pôle Psychiatrie Précarité, GHU Paris Psychiatrie et Neurosciences, Paris, France. Pôle G-, GHU Paris Psychiatrie et Neurosciences, Paris, France. Pôle G, GHU Paris Psychiatrie et Neurosciences, Paris, France. Esquirol Hospital, Saint-Maurice, France. Mental Health Association of the th (ASM), Paris, France. Pôle , GHU Paris Psychiatrie et Neurosciences, Paris, France.

Abstract summary 

Seclusion or restraint (S/R) are last-resort measures used in psychiatry to ensure the safety of the patient and the staff. However, they have harmful physical and psychological effects on patients, and efforts to limit their use are needed. We describe the characteristics and correlates of S/R events in four Parisian psychiatric centers.Within a 3-month period, November 5, 2018 to February 3, 2019, we recorded data for patients experiencing an S/R measure as well as characteristics of the measures. We studied the mean duration of a S/R event, the time between hospital admission and the occurrence of the event, as well as correlates of these durations. We also examined factors associated with use of a restraint versus a seclusion measure.For the 233 patients included, we recorded 217 seclusion measures and 64 mechanical restraints. Seclusion measures mostly occurred after the patient's transfer from the emergency department. The duration of a seclusion measure was about 10 days. Patients considered resistant to psychotropic treatments more frequently had a longer seclusion duration than others. The mean duration of a mechanical restraint measure was 4 days. Male sex and younger age were associated with experiencing mechanical restraint.S/R measures mostly occur among patients perceived as resistant to psychotropic drugs who are arriving from the emergency department. Developing specific emergency department protocols might be useful in limiting the use of coercive measures.

Authors & Co-authors:  Dauriac-Le Masson El-Khoury Lesueur Lahaye Launay Christodoulou Boiteux Maman Bonnemaison Perquier Vacheron

Study Outcome 

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Citations :  Al-Maraira OA, Hayajneh FA. Use of restraint and seclusion in psychiatric settings: A literature review. J Psychosoc Nurs Ment Health Serv. (2019) 57:32−9. doi: 10.3928/02793695-20181022-01
Authors :  10
Identifiers
Doi : 1296356
SSN : 1664-0640
Study Population
Male
Mesh Terms
Other Terms
duration of seclusion;organization of care;predictive factors;prevention;psychiatric inpatients;restraint;seclusion
Study Design
Study Approach
Country of Study
Publication Country
Switzerland