title: Understanding Mental Health Service User Experiences of Restraint Through Debriefing: A Qualitative Analysis.
abstract: OBJECTIVE
  To examine debriefing data to understand experiences before, during, and after a restraint (seclusion, chemical, and physical) event from the perspective of inpatients at a large urban mental health and addiction hospital.
  
  
  METHODS
  Audits were conducted on a purposeful sample of inpatient charts containing post-restraint event inpatient debrief forms (n = 55). Qualitative data from the forms were analyzed thematically.
  
  
  RESULTS
  Loss of autonomy and related anger, conflict with staff and other inpatients, and unmet needs were the most common factors precipitating restraint events. Inpatients often reported that increased communication with staff could have prevented restraint. Inpatients described having had various negative emotional states and responses during restraint events, including fear and rejection. Post-restraint, inpatients often desired to leave the unit for fresh air or to engage in leisure activities.
  
  
  CONCLUSIONS
  To our knowledge, our study is the first to use debriefing form data to explore mental health inpatients' experiences of restraint. Inpatients view restraint negatively and do not experience it as a therapeutic intervention. Debriefing, guided by a form, is useful for understanding the inpatient's experience of restraint, and should be used to re-establish the therapeutic relationship and to inform plans of care. In addition, individual and collective inpatient perspectives should inform alternatives to restraint.
authors.affiliation: Advanced Practice Nurse, Centre for Addiction and Mental Health, Toronto, Ontario.
authors.forename: Sara
authors.initials: S
authors.lastname: Ling
authors.affiliation: Assistant Professor, Centre for Addiction and Mental Health Chair in Mental Health Nursing Research, Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario; Clinician-Scientist, Centre for Addiction and Mental Health, Toronto, Ontario.
authors.forename: Kristin
authors.initials: K
authors.lastname: Cleverley
authors.affiliation: Senior Project Manager, Centre for Addiction and Mental Health, Toronto, Ontario.
authors.forename: Athina
authors.initials: A
authors.lastname: Perivolaris
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008605:Mental Health Services; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D010356:Patient Isolation / Q000523:psychology*; D036301:Qualitative Research; D012149:Restraint, Physical / Q000523:psychology*