A "no-restraint" psychiatric department: operative protocols and outcome data from the "Opened-doors experience" in...

The "Open Doors" and no restraint project in the psychiatric department of Trento originated from de-institutionalization and empowerment practices, amply extended in the Mental Health Service of Trento over the past years. This paper aims to present the authorized operative protocols of no restraint methods and data from the first four years experience of no restraint management in the psychiatric Department of Trento. Avoiding physical restraint and confinement force every member of the ward staff to look for innovative solutions and means a deeper and strenuous engagement of the staff in the therapeutic relationship. We are aware that this is basically a small thing, and that certainly it will create many contradictions. We chose to stay on the other hand in these contradictions, and to witness that it is possible, and indeed useful. The great lesson we learnt over past years in Community Psychiatry was that only the hard experience of these contradictions can allow people to regain health, not just as assimilation to stereotyped models, but as adhibition of resources and self-determination, normally stolen by psychiatric illness.