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Peering into the Dynamics of Social Interactions: Measuring Play Fighting in Rats

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When Structural Inequity Is Ubiquitous, Can Force Ever Be Compassionate?

Sriya Bhattacharyya¹, Aaron S Breslow², Jianee Carrasco³

¹Postdoctoral research fellow in health disparities and multicultural mental health with a dual affiliation at the Health Equity Research Lab at Harvard Medical School in Cambridge, Massachusetts, and the PRIME Center for Health Equity at Albert Einstein College of Medicine/Montefiore Medical Center in New York City.

AMA Journal of Ethics

|May 5, 2021

Summary

Psychiatric use of force, including seclusion and restraint, shows significant race, class, and gender inequity. Systemic oppression fuels fear and retraumatization, necessitating multilevel strategies to abolish these disparities in clinical settings.

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Published on: February 16, 2011

Area of Science:

Psychiatry
Sociology
Health Equity

Background:

Psychiatric settings grapple with the persistent issue of using force, such as seclusion and restraint.
Existing policies and legal frameworks often fail to address underlying systemic inequities.
The impact of force on patients, including fear and retraumatization, is a critical concern.

Purpose of the Study:

To examine race, class, and gender inequities in the psychiatric use of force.
To analyze the codification of force (seclusion, restraint, compulsion) in policy and law.
To explore the links between systemic oppression and patient responses to force.

Main Methods:

Policy and legal analysis of force utilization.
Examination of inequity in force application.
Exploration of connections between systemic oppression and patient experiences.

Main Results:

Uses of force like seclusion, restraint, and compulsion are codified in policy and law.
Significant inequities in force utilization based on race, class, and gender are evident.
Systemic oppression is linked to patient fear and retraumatization in clinical settings.

Conclusions:

Multilevel strategies are proposed to abolish inequity in the use of psychiatric force.
The possibility of compassionate force application amidst persistent inequity is questioned.
Addressing systemic oppression is crucial for reducing harm in psychiatric care.