Physical restraint in Polish psychiatric facilities

Physical restraint in the form of direct force, forced feeding and medication, mechanical restriction of bodily movement, or the threat of force was administered to close to 30% of patients admitted and hospitalized for a period of at least fourteen days. In transporting the patient to the admission room and then to his treatment ward, the dominant form of restraint used was direct force, or the threat of such force. During the following fourteen days of hospitalization, mechanical restraint and forced medication predominated. Restraint was applied most often, across each of the four phases of the study, to patients deemed dangerous to self or others. This relationship became significantly stronger as the period of hospitalization continued. Across the four phases, patients who protested their hospitalization were more likely to be restrained than patients who agreed to it or who did not object. During each of the four phases of the study, numerous patients who did not object to their hospitalization and who were not deemed dangerous were nevertheless subjected to restraint. The pervasiveness of physical restraint, the wide inter-hospital differences in its use, the apparent over-prediction of patient dangerousness, and the use of restraint with patients who were not deemed dangerous and who did not object to their hospitalization, confirms the need for legal and ethical regulation of physical restraint of psychiatric patients.