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What Is Psychiatric Restraint?

By Jillian O Keeffe
Updated May 17, 2024
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When a person is suffering from a psychiatric condition, he or she may act in a way that is not reflective of his or her normal personality. If the person becomes aggressive, or poses a danger to other people or to himself or herself, then mental health professionals may have to employ a psychiatric restraint. Examples of a psychiatric restraint include holding a patient down manually, giving the patient calming drugs, or securing the person with mechanical restraints such as wrist cuffs.

Psychiatric institutions deal with people who may have conditions that make their behavior unpredictable, or unusually aggressive or depressive. Generally, in most countries, the primary treatment for the patients involves psychiatric therapy and drugs. This combination of approaches can benefit some patients and help to keep them in a balanced state of mind. Sometimes, however, patients do not respond well to treatment, or experience lapses into uncontrollable behavior, and in these situations, the staff at the institution may have to resort to psychiatric restraint.

Typically, psychiatric restraint is only used when necessary to protect the patient and the people around the patient. For times when a person exhibits undesirable behavior that does not pose such a risk, the psychiatric staff may be able to handle the problem by talking to the patient or providing an activity to do. When a person becomes more excitable, aggressive or tries to hurt himself or herself, then the supervising staff may have to employ restraint methods when milder measures do not calm the patient.

Drugs are one form of psychiatric restraint, and some patients who are uncontrollable may receive injections of a medication to calm them. The staff may manually hold people down for a period of time until the undesirable mood has passed. Alternatively, the patient may be physically restrained with mechanical devices such as tying down wrists.

Generally, it is psychiatric nurses that make the decision to employ restraints on an individual. Whether a psychiatrist has to check the restraints and the patient can depend on individual countries and regulations. Possible reasons for restraint usage, apart from violent behavior, include refusal to comply with staff instructions, rejection of medication and attempted escape. The staff in these cases use the restraints in order to keep the psychiatric unit running smoothly, and keep the patient on track with medication.

Risks apply to each type of psychiatric restraint. Medications to soothe the patient or to make the patient less excitable have possible side effects, as do all drugs in general. People who undergo physical restraints may suffer injuries from being held down which may range from bruises to potentially lethal injuries such as suffocation. Mechanical restraints may also cause similar injuries, although typically, manufacturers design the restraints to be as safe as possible.

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Discussion Comments

By bear78 — On May 02, 2014

As far as I know, the American Psychiatric Association has clear definitions and rules about psychiatric restraint and when and how it may be used. For example, I know that it is usually not used for children or young adults. This is a decision that health professionals have to make depending on the situation. They have to weight the risks and benefits and use restraint if the benefits are greater.

My mom is a nurse in the emergency room and she said that restraint is the last option but sometimes it's necessary.

By candyquilt — On May 01, 2014

@donasmrs-- I don't agree with you. Psychiatric restraint isn't a form of treatment and it's not used unless it's absolutely necessary. It is used to keep people from harming themselves and others and it's a temporary precaution. If you spend just one day at a psychiatric ward, you will realize the need for psychiatric restraint.

Unfortunately, some people are suffering from severe mental health conditions that cause them to behave in abnormal ways. The individual might be suicidal or violent due to paranoia, depression, anxiety and hallucinations. In some stages of illness, such individuals are also very physically strong and impossible to maintain without some sort of restraint. Restraint might seem inhumane to you but it's better than that person harming or killing themselves or someone near them.

I interned for a short time at a psychiatric ward and witness psychiatric restraint being used several times. In each case, the patient was uncontrollable, was in complete rage and threatened to harm himself or someone else. So I don't think that psychiatric restraint is inhumane.

By donasmrs — On May 01, 2014

I think that some forms of psychiatric restraint are inhumane. I don't think wrist cuffs and straitjackets should be used. Tying someone to a bed is inhumane as well. Modern medicine needs to find new ways to help psychiatry patients.

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