Exploring psychiatric patient restraints: Balancing safety, ethics, and patient rights in mental healthcare

• Published in: Asian journal of psychiatry Vol. 96; p. 104051
• Main Authors: Paul, Fayaz Ahmad, Ganie, Aasim Ur Rehman, Dar, Danishwar Rasool, Saikia, Priyanka, Banerjee, Indrajeet
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-06-2024
• Subjects: Assault; Chemical; Humans; India; Mental Disorders - therapy; Mental Health Services - standards; Patient Rights; Patient Safety - standards; Physical; Prevention; Psychological; Restraint; Restraint, Physical - ethics; Seclusion; India; Psychological; Prevention; Physical; Chemical; Restraint; Assault; Seclusion
• ISSN: 1876-2018; 1876-2026; 1876-2026
• DOI: 10.1016/j.ajp.2024.104051

Restraint, often linked with limiting an individual's freedom of movement, has become a focal point of extensive discussion and evaluation within the realm of mental healthcare. Striking a delicate balance between ensuring individual safety and minimizing reliance on restraint methods poses a significant challenge. In mental health inpatient settings, the prevalent forms of restraint encompass physical, chemical, environmental, and psychological methods. Paradoxically, the consequences of employing restraint can be severe, ranging from injuries and cognitive decline to sedation and, in extreme cases, fatalities. This paper seeks to offer a nuanced exploration of the landscape surrounding psychiatric patient restraints, considering both global perspectives and specific insights from the Indian context. The guidelines outlined in India's Mental Healthcare Act of 2017, which governs the use of restraint on individuals suffering with mental illnesses, are also examined in detail.
•Aggressive, self-harming, and violent behavior is common in psychiatric wards, posing risks to patients and staff•Empirical research on the subject is limited, and the ethical implications of restraint are significant•Aggressiveness and violence are frequent in mental health settings, often connected to emotional dysregulation•Factors such as overcrowding, staff shortages, and financial constraints contribute to the violence•Proper procedures, training, and monitoring are crucial to minimize risks and legal issues associated