| There is a lack of available data to guide clinical practice of staff decision to use restraint or seclusion. Clinical application of restraint and seclusion vary widely across psychiatric settings. Studies examining patient factors have yielded mixed results. Staff education, experience, perceptions, and appraisal of patient characteristics most notably impact rates of patient restraint and seclusion. Indications for restraint and seclusion are poorly defined consistently across both forensic and general psychiatric settings. These interventions are both indicated and contraindicated as effective strategies for treatment and management of challenging behaviors in inpatient psychiatric settings. An objective examination of patient factors is needed to understand the association between patient factors and restraint use in forensic psychiatric settings. Research shows that training in prediction and prevention affectively reduces restraint and seclusion. This study examined group differences in patient restraint and factors that predict the probability of future restraint in order to facilitate the development of consumer based alternatives to restraint and seclusion. A two-factor model, comprised of MMPI-2 scales Mf and Pa, correctly classified 66% of patient restraint and non-restraint groups. Results from this study and similar research can be used to foster the development of consumer-driven alternative strategies to restraint and seclusion. |
