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However, I would also argue that, for most acute psychiatric settings, total elimination of seclusion and restraint is not a practical goal unless one puts dogma ahead of both patient safety and staff safety. Rather, I would argue that the goal should be safe, judicious, and minimal use of seclusion and restraint.

Al Herzog, M.D.

Footnotes

Dr. Herzog is vice-president of medical affairs at Hartford Hospital in Hartford, Connecticut, and professor of clinical psychiatry at the University of Connecticut School of Medicine in Farmington.

References

1. Donat DC: Encouraging alternatives to seclusion, restraint, and reliance on PRN drugs in a public psychiatric hospital. Psychiatric Services 56:1105–1108,2005[Abstract/Free Full Text]
2. LeBel J, Goldstein R: The economic cost of using restraint and the value added by restraint reduction or elimination. Psychiatric Services 56:1109–1114,2005[Abstract/Free Full Text]
3. Smith GM, Davis RH, Bixler EO, et al: Pennsylvania state hospital system's seclusion and restraint reduction program. Psychiatric Services 56:1115–1122,2005[Abstract/Free Full Text]
4. Frueh BC, Knapp RG, Cusack KJ, et al: Patients' reports of traumatic or harmful experiences within the psychiatric setting. Psychiatric Services 56:1123–1133,2005[Abstract/Free Full Text]
5. Robins CS, Sauvageot JA, Cusack KJ, et al: Consumers' perceptions of negative experiences and "sanctuary harm" in psychiatric settings. Psychiatric Services 56:1134–1138,2005[Abstract/Free Full Text]

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