Book contents
- Frontmatter
- Contents
- List of contributors
- Preface to second edition
- Preface to first edition
- Foreword
- Part I Therapeutic interventions
- 1 Psychiatric intensive care – development and definition
- 2 Management of acutely disturbed behaviour
- 3 De-escalation
- 4 Rapid tranquillisation
- 5 Pharmacological therapy
- 6 Psychological approaches to the acute patient
- 7 Psychological approaches to longer-term patients presenting with challenging behaviours
- 8 Seclusion – past, present and future
- 9 Restraint and physical intervention
- 10 The complex needs patient
- 11 Therapeutic activities within Psychiatric Intensive Care and Low Secure Units
- 12 Risk assessment and management
- Part II Interface issues
- Part III Management of the Psychiatric Intensive Care Unit/Low Secure Unit
- Index
- References
9 - Restraint and physical intervention
from Part I - Therapeutic interventions
Published online by Cambridge University Press: 22 August 2009
- Frontmatter
- Contents
- List of contributors
- Preface to second edition
- Preface to first edition
- Foreword
- Part I Therapeutic interventions
- 1 Psychiatric intensive care – development and definition
- 2 Management of acutely disturbed behaviour
- 3 De-escalation
- 4 Rapid tranquillisation
- 5 Pharmacological therapy
- 6 Psychological approaches to the acute patient
- 7 Psychological approaches to longer-term patients presenting with challenging behaviours
- 8 Seclusion – past, present and future
- 9 Restraint and physical intervention
- 10 The complex needs patient
- 11 Therapeutic activities within Psychiatric Intensive Care and Low Secure Units
- 12 Risk assessment and management
- Part II Interface issues
- Part III Management of the Psychiatric Intensive Care Unit/Low Secure Unit
- Index
- References
Summary
Introduction
Throughout the ages, virtually all complex societies have found the need for containment and control of behaviour by physical means. Indeed, it is difficult to imagine a world without prisons, police and the periodic need for society to impose its collective standard of behaviour on individuals.
While most people share a degree of comfort with the notion of physical intervention to maintain law and order, its use under the justification of mental health ‘care’ is deeply troubling to many, with some arguing it has no place at all (Davis 2004). The first words in any discussion about restraint must include the methods of avoiding the need for its use wherever possible. De-escalation, negotiation and the development of trusting relationships have been covered in detail elsewhere in this volume and the reader is advised to consider these issues as an essential first step. The focus here will be confined to the activity of restraint, assuming that due attention has already been paid to the methods of avoiding the need for its use.
Restraint and physical intervention: the questions
In mental health care, the use of restraint, both mechanical and inter-personal, has a long and chequered history. In recent years, the use of restraint has come under increasing scrutiny. In the UK and the USA, death during restraint has been increasingly reported (Appelbaum 1999; Paterson et al. 2003).
- Type
- Chapter
- Information
- Psychiatric Intensive Care , pp. 123 - 131Publisher: Cambridge University PressPrint publication year: 2008
References
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