Psychiatric inpatients' experiences with restraint

Abstract

Twelve psychiatric inpatients were qualitatively interviewed after physical restraint. Of these, seven had also been pharmacologically restrained. Patients gave refusal of medication, refusal to follow staff directions, or their own aggression, as reasons why they had been restrained. While some felt that the use of restraint had been warranted, others were more critical. Many thought that restraint could have been avoided. Patients felt that being restrained evoked feelings of anxiousness, anger, and hostility. Some reported that they calmed down after having been restrained, while other did so only after having received additional pharmacological restraint. A few had suffered minor abrasions and two reported revived memories of prior abuse. Several believed that the use of restraint did protect them from hurting themselves or others. Some felt angry, fearful, and distrustful of staff after restraint, and some believed it had damaged the provider – patient alliance. Patients that had psychotic symptoms during restraint were more understanding of staff's decision to restrain. It is important to systematically debrief patients after restraint, thus helping patients understand why restraint was used and identify early problems that arise following the intervention. It is necessary to train staff in the early detection of aggression and in the use of less restrictive interventions.

Keywords:

• coercion
• physical restraint
• pharmacological restraint
• patients'
• experiences
• psychiatry
• inpatients

ACKNOWLEDGEMENTS

The author is grateful for the kind help of Professor Hal Sexton. The study was supported by a grant from the Psychiatric Research Center for Northern Norway (NNPF).