The use of restraint on patients in Israeli psychiatric hospitals

This first-ever study of the use of restraint on psychiatric patients in Israel sought to determine the dominant motivations in the decision to use restraint, which patients were most likely to be restrained, and whether there was a consistent policy on the matter. A survey of the official records of every instance of restraint during one month in the closed wards of all government psychiatric hospitals, supplemented with interviews, revealed that 14.2% of the study population had undergone restraint. The declared reasons were conventional, i.e. violence, disturbed behaviour, etc. Undeclared was an interaction between patients and staff, both the most professional and the less skilled, which surprised the authors and requires more investigation. Some subgroups, e.g. women and certain immigrant groups, were restrained markedly more frequently than other groups. No consistency of policy was found. Overall, much of the restraint applied is deemed unnecessary and recommendations are made for its reduction.