Use of physical restraints in a nineteenth-century state hospital

Abstract

Archival records of physical restraint usage at the St. Louis Insane Asylum (now the St. Louis State Hospital) were examined from January through June 1885. The demographics of restrained patients were determined from archival admission records. In the 6-month (181-day) sample period, 53 patients accounted for the total of 2,537 incidents of night restraint. Sixty percent of the restrained patients were women and 53% were immigrants. By far most (98.5%) of the incidents of restraint were brought on by violent behaviour (fighting, destroying property, injury to self) while most incidents in modern hospitals result from verbal threats or shouting. When these records were combined with day restraint records from the same 6-month period in 1889, an overall incidence rate of 9.7% per month was estimated. This is similar to rates reported from modern psychiatric hospitals. Possible reasons for the discrepancies and similarities in the types of patients restrained and the activities which brought on restraint in the nineteenth and twentieth centuries are discussed.

Perceptions of Seclusion and Restraint by Patients and Staff in an Intermediate-Term Care Facility

“…Little of practical relevance to the institutional setting has followed from these studies. Patients contjnued to be restrained at rates that differed across similar settings, but the rates remained very similar to historical numbers (Esther, 1997;Persi & Pasquali).…”

The Utica crib: Biography of an unknown barbarous object.

“…The device remained sporadically popular across institutions: Daniel Hack Tuke (1885), of the famed York Retreat, reported 111 patients in American institutions occupying covered bedsteads only 2 years prior-a number he believed to be an underestimate, given that not all superintendents regarded the device to be a type of restraint. With data from the same year, Robert Esther (1997) found that the covered bedstead remained the fourth most commonly used restraint at the St. Louis Insane Asylum, accounting for 12% of the 2,537 incidents recorded during a 6-month period. Similarly, the Topeka Daily Capital reported in 1887 that the beds were still in use in institutions across Kansas (Redjinski, 1971), and crib-beds were listed among the restraints in use at the Beauport Asylum in Quebec in 1888 (Hurd, 1916(Hurd, -1917.…”

“…In presenting a biography of an object, this article joins the growing number of histories that have recently drawn attention to the material culture of psychiatric institutions (e.g., Coleborne, 2001; Esther, 1997; MacKinnon, 2006; Majerus, 2011; Penney & Stastney, 2009; Willis, 1995; Wynter, 2011). Most persuasively, Dolly MacKinnon and Catharine Coleborne recently demonstrated that institutional practices become increasingly discernible through their material and visual cultures (MacKinnon & Coleborne, 2011).…”