Monitoring Use of Restraint and Seclusion in State Psychiatric Hospitals


DRC’s IU staff monitored the use of restraint and seclusion practices, as well as the pattern of aggressive acts and serious incidents, at state hospitals.  DRC reviewed and analyzed data pertaining to: the use of restraint and seclusion on patients; restraint/seclusion related injuries to staff and patients; injuries to patients and staff from patient aggressive acts; restraint or seclusion injuries or deaths reported to DRC; and other serious incidents suggestive of criminal abuse reported to DRC (unexpected/suspicious deaths, sexual assault allegations involving staff, physical abuse reported by staff that was in turn reported to local law enforcement).  

DRC concluded that the use of restraint and seclusion was increasing in most state hospitals, and that there was an increase in documented staff injuries during incidents of restraint or seclusion.  IU staff noted that patient to patient aggressive acts, and patient to staff aggression has decreased.  The monitoring raised the following issues: data posted on the Department of State Hospitals (DSH) website is cumbersome to review and unreliable.  Further, there are questions about the consistency of reporting across DSH facilities, and questions about how DSH is using the data collectively.   DRC met with one responsive state hospital director to discuss these issues.  DRC plans to meet with DSH administration in 2014.