Variations in seclusion and restraint practices by hospital location

Data from a survey of seclusion and restraint practices in New York state hospitals were analyzed to determine if they differed by hospital location. The study included 19 hospitals--five in New York City, four in New York City suburbs, three in large towns, and seven in small towns. Overall, New York City and large-town hospitals had the highest rates of seclusion and restraint, but analysis by age group showed that New York City had the lowest rate for patients under age 35, who constituted the majority of patients who were secluded or restrained, and large towns had the highest rate. Compared with suburban and small-town hospitals, city and large-town hospitals used seclusion more often than restraint and had a higher ward census and a lower-staff patient ratio. In all groups males and blacks were overrepresented compared with the hospital population. The authors believe clarification of regional variations in assaultive behavior is important for treatment and system planning.