Psychiatric Restraint

An intervention with risks and benefits, no matter how grim

Yesterday's New York Times featured a remarkable article about psychiatric restraint, as presented at the American Psychiatric Association. If you read this newsletter, you owe it to yourself to read that article. It describes a presentation at the APA annual meeting by a former patient who experienced a traumatic psychiatric restraint.

I have been a critic of inpatient psychiatric care as it's currently practiced—in that it doesn’t reduce death by suicide. When I worked in inpatient settings, much of my time was spent thinking about how to reduce the use of restraint. I am a child and adolescent psychiatrist, so the trauma associated with psychiatric restraint was evident. I’ve written about that topic before, also.

I was proud to work on teams that understood how pernicious restraint and seclusion could be from very early in my training, including medical school. When I was in medical school, I was introduced to collaborative problem-solving, an approach developed by Dr. Ross Gre…