Staff opinions about seclusion and restraint at a state forensic hospital

The purpose of the study was to obtain staff opinions on the use of seclusion and restraint with acutely psychotic psychiatric patients in a forensic hospital.

A 40-item questionnaire was distributed to 129 staff members who routinely used these techniques. Descriptive statistics, intercorrelations, and analyses of variance were used to examine patterns of response.

Of the 109 respondents, 63 percent favored the use of medications over physical procedures, and 65 percent said that they would order seclusion over restraint if medications could not be used. Responses indicated that staff tended to choose to treat patients as they themselves would want to be treated. Staff with more education, including psychologists and social workers, believed that staff other than physicians should have the authority to write seclusion and restraint orders. Female staff believed that patients experienced seclusion or restraint as positive attention, while male staff believed that it was a negative experience. Staff with more education believed that restraints, seclusion, and medication were overused.

The findings that gender and level of education affect staff's use of physical procedures with acutely psychotic patients have important implications for staff training.