Managing treatment resistant violent adolescents: a step forward by substituting seclusion for mechanical restraint?
Despite a growing consensus that seclusion or restraint should never be used with children or adolescents, there are a few patients who are resistant to treatment, and are persistently violent. The purpose of this study was to measure the efficacy of installing a padded seclusion room to decrease the use of mechanical restraints, a potentially more emotionally traumatic and dangerous intervention than seclusion. After padded room installation, the number of monthly mechanical restraint events per 1000 patient days decreased by 93.7%, from 21.2 to 1.3. A padded seclusion room may offer a safer, albeit a less than desirable alternative to mechanical restraint.
Larson
Thomas C
TC
Child and Adolescent Psychiatry, Dorothea Dix Hospital, 3601 MSC Center, Raleigh, NC 27699, USA. Tom.larson@ncmail.net
Sheitman
Brian B
BB
Kraus
John E
JE
Mayo
James
J
Leidy
LuAnn
L
D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D010356:Patient Isolation / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D014754:Violence / Q000517:prevention & control*