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Published Online: 1 September 2005

Special Section on Seclusion and Restraint: Encouraging Alternatives to Seclusion, Restraint, and Reliance on PRN Drugs in a Public Psychiatric Hospital

Abstract

Reliance on seclusion, restraint, and psychotropic PRN (as needed) medication for behavior management has been tied to a variety of untoward outcomes that detract from the quality of care in public psychiatric hospitals. A large body of evidence has accumulated to demonstrate that behavioral approaches to care can provide useful alternatives to reliance on seclusion, restraint, and psychotropic PRN medications. This article draws from the research to outline how behavioral approaches to psychiatric care can assist in realizing alternatives to these restrictive interventions. Strategies to assess the behavioral competence of direct care staff, improve it, and establish ward programmatic structures that facilitate competent behavioral applications are discussed as well as methods to enable expert consultation and demonstrate clinical and administrative support. These steps have had a positive impact in reducing reliance on seclusion, restraint and psychotropic PRN medication in the inpatient psychiatric setting. Given the wealth of supportive data to confirm the value of behavioral applications, there is no excuse for failing to aggressively pursue these options.

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Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 1105 - 1108
PubMed: 16148325

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Published online: 1 September 2005
Published in print: September 2005

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Dennis C. Donat, Ph.D.

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