Commentary: On regulation, wishfulness, and denial

Area of Science:

• Psychiatry
• Clinical Psychology
• Healthcare Education

Background:

• Restraint and seclusion are underemphasized in clinical training, despite frequent encounters with aggression in practice.
• Current policy standards for these interventions are outdated, with no official updates since the 1980s.
• The American Psychiatric Association's 2003 committee to revise standards of care has not led to official updates.

Purpose of the Study:

• To highlight the inadequate training and outdated standards surrounding the use of restraint and seclusion.
• To emphasize the need for improved education on managing aggressive behaviors in clinical practice.

Main Methods:

• Analysis of current training practices and policy standards regarding restraint and seclusion.
• Review of historical guidelines and committee recommendations from professional organizations.

Main Results:

• Training on restraint and seclusion principles is often inconsistent, relying on in-house or agency-specific methods.
• Violence and aggression receive minimal curriculum coverage compared to other psychiatric disorders.
• Established policy standards have not been officially updated for decades.

Conclusions:

• There is a significant deficiency in formal education and standardized guidelines for restraint and seclusion.
• Improved and updated training protocols are crucial for addressing aggression and ensuring patient safety in clinical settings.