Factors influencing decisions on seclusion and restraint

Abstract

Seclusion with or without restraint is a measure for managing aggressive or agitated clients and promoting site security, particularly in an emergency psychiatric setting. The decision to control a potentially dangerous person's behaviour by removal or seclusion seems ethically justifiable in such a setting. However, although the decisions on these restrictive measures are based on rational needs, they are also influenced by the healthcare team's perceptions of the client and by the characteristics of the team and the environment. The purpose of this paper is to set out and categorize the factors in play in aggression- and agitation-management situations as perceived by the healthcare teams, particularly the nurses. The first part of the paper deals briefly with the settings in which control measures are applied in a province in eastern Canada and the effect of such measures on patients and healthcare teams. The second part identifies the factors involved in the management of agitation and aggression behaviour. The final part discusses the current spin-offs from this knowledge as well as promising paths for further research on the factors involved. The ultimate objective is to reduce recourse to coercive measures and enhance professional practices.

Nursing Staff Factors Contributing to Seclusion in Acute Mental Health Care – An Explorative Cohort Study

“…Larue, Dumais, Ahern, Bernheim, and Mailhot (2009) This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/./), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.…”

Coercion in Forensic Healthcare: A North American Perspective

“…Another major influence in the debate surrounding SR use is the relative lack of uniform legislations across Canada and America (see Sect. 10.2 in this chapter); within the framework of the Canadian Charter of Rights and Freedom, the measurement and regulation of SR use is left to local government and often to individual institutions (Larue et al 2009;Chaimowitz 2011 Hui et al 2013). …”

La médication psychiatrique comme contention : entre autonomie et protection, quelle place pour un cadre juridique ?

“…Pourtant, bien que la littérature scientifique sur l'isolement et les contentions soit abondante (Larue et al, 2009 ;Knutzen et al, 2007 ;Pollard et al, 2007), peu de chercheurs, de cliniciens, d'éthi -ciens ou de juristes s'intéressent à la question de la contention chimique (Currier, 2003).…”