Project leads: Katy Kruse, Hannah Reynard (Psychiatry )

Background: Physical restraints and seclusion are used in psychiatric settings to prevent patients from injuring themselves or others while managing their agitation in order to deliver appropriate care. While critical in some cases to reduce the potential for harm, restraints and seclusion can themselves generate harm, including causing physical and emotional distress to patients and families. As a result, it is important to ensure they are used only when necessary.

Project aim: To evaluate whether restraints and seclusion are applied equitably in the Nyman Family Unit for Child and Adolescent Mental Health and Wellness general bed-wing and subunit for youth with significant behavioral or developmental needs.

Project status: This project is complete.  It identified several inequities in restraint and seclusion use over a seven-year period in Nyman. Boys were more likely to experience 4-point leather restraints. In the general bed-wing, Black patients were more likely to experience any type of restraint. In the subunit, patients categorized as “Other” were less likely to experience restraints, including seclusion and physical management. These findings suggest that patient demographic characteristics may influence how restraints are used. However, the study did not account for important clinical or social factors—such as severity of mental illness or caregiver presence—that may affect restraint use, nor did it examine the role of chemical restraints.