As Time Goes by: Reasons and characteristics of prolonged episodes of mechanical restraint in forensic psychiatry

Frederik Alkier Gildberg, Peter Billeskov Fristed, Guido Makransky, Elsebeth Holten Møller, Lea Deichmann Nielsen, Stephen K. Bradley

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Evidence suggests the prevalence and duration of mechanical restraint are particularly high among forensic psychiatric inpatients. However, only sparse knowledge exists regarding the reasons for, and characteristics of, prolonged use of mechanical restraint in forensic psychiatry. This study therefore aimed to investigate prolonged episodes of mechanical restraint on forensic psychiatric inpatients. Documentary data frommedical records were thematically analyzed. Results show that the reasons for prolonged episodes of mechanical restraint on forensic psychiatric inpatients can be characterized by multiple factors: "confounding" (behaviors associated with psychiatric conditions, substance abuse, medical noncompliance, etc.), "risk" (behaviors posing a risk for violence), and "alliance parameters" (qualities of the staff-patient alliance and the patients' openness to alliance with staff), altogether woven into a mechanical restraint spiral that in itself becomes a reason for prolonged mechanical restraint. The study also shows lack of consistent clinical assessment during periods of restraint. Further investigation is indicated to develop an assessment tool with the capability to reduce time spent in mechanical restraint.

Original languageEnglish
JournalJournal of Forensic Nursing
Volume11
Issue number1
Pages (from-to)41-50
Number of pages9
ISSN1556-3693
DOIs
Publication statusPublished - 2015

Keywords

  • aggression
  • forensic
  • restraint
  • risk assessment
  • risk management
  • Anger
  • Forensic Psychiatry
  • Aggression
  • Violence
  • Humans
  • Hospitalization
  • Patient Safety
  • Mental Disorders/psychology
  • Restraint, Physical

Fingerprint

Dive into the research topics of 'As Time Goes by: Reasons and characteristics of prolonged episodes of mechanical restraint in forensic psychiatry'. Together they form a unique fingerprint.

Cite this