NCJ Number
119158
Date Published
1989
Length
24 pages
Annotation
This analysis of the use of physical restraints to control dangerous behavior in children and adolescents in psychiatric inpatient settings emphasizes philosophical, legal, and clinical issues and suggests practical guidelines for use by treatment staff.
Abstract
Discussions of restraints arouse strong emotions, although few disagree that dangerous behavior must be stopped. Staff in psychiatric hospitals are usually ambivalent about the use of restraints. However, childhood is definable by its need for adult support. Limits exist for all children, and those committed to mental hospitals are either a danger to others, a danger to themselves, or unable to manage themselves safely. Although the legal system has varied in its emphasis on due process versus medical judgment regarding commitment and restraint, due process and patient rights are receiving increasing attention. The basic justification for imposing restraints on freedom is protection of the person restrained, of others, or of both. Staff need careful training in attitudes and techniques of initiating, monitoring, and reviewing restraint. Other important issues relate to the termination of episodes of restraint, assessing the proper incidence of restraint on a psychiatric ward for children, comparing incidents of restraint, the concept of punishment as one aspect of restraint, and the extent of the child's accountability for undesirable behavior. 29 references.