Restraint and Seclusion: A Risk Management Guide

Over the past decade the use of restraint and seclusion has come under intense scrutiny as researchers and clinicians have chronicled the significant physical and psychological risks – including death, disabling physical injuries, and significant trauma – inherent in each use of the interventions. Also during this time, many effective, inexpensive alternatives to restraint and seclusion were developed, demonstrating that their use can safely be reduced.

This paper is intended to:

• Provide background on the increased scrutiny of the use of restraint and seclusion, including a discussion of the political, legal, and regulatory context regarding the use of these interventions for people with mental illnesses;
• Provide a brief overview of factors explaining why the use of restraint and seclusion poses legal risks, including a description of the medical risks associated with the use of these interventions;
• Provide an overview of the constitutional, civil, and criminal claims that may arise when seclusion and restraint are used improperly, and review relevant case law;
• Provide examples of effective alternatives to the use of restraint and seclusion and related resources;
• Recommend practical strategies to reduce risks to providers and facilities.

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