Efforts to reduce seclusion and restraint use in a state psychiatric hospital: A ten-year perspective

Alok Madan, Jeffrey J. Borckardt, Anouk L. Grubaugh, Carla Kmett Danielson, Stephen McLeod-Bryant, Harriet Cooney, Joan Herbert, Susan J. Hardesty, B. Christopher Frueh

Research output: Contribution to journalArticle

13 Scopus citations


Objective: The authors previously demonstrated an 82.3% reduction in seclusion and restraint use at an inpatient psychiatric facility, largely attributable to changes to the physical environment. This study investigated whether the reduction was sustained over time. Methods: This follow-up study examined archival data by using a longer preintervention baseline phase and examined the sustainability of intervention gains in the absence of a research agenda. Over ten years, 3,040 seclusion and restraint incidents were analyzed across 254,491 patient-days. Results: The extended baseline phase (N=38 months) exhibited a linear trend upward in seclusion and restraint use, and the formal intervention period and subsequent follow-up periods (N=82 months) showed a stabilization effect (p<.001). Conclusions: The findings suggest that reduction in seclusion and restraint use is sustainable, and judicious use of seclusion and restraint can become the new normative practice - even in the face of potentially disruptive administrative and environmental changes.

Original languageEnglish (US)
Pages (from-to)1273-1276
Number of pages4
JournalPsychiatric Services
Issue number10
StatePublished - Oct 1 2014


ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Madan, A., Borckardt, J. J., Grubaugh, A. L., Danielson, C. K., McLeod-Bryant, S., Cooney, H., Herbert, J., Hardesty, S. J., & Frueh, B. C. (2014). Efforts to reduce seclusion and restraint use in a state psychiatric hospital: A ten-year perspective. Psychiatric Services, 65(10), 1273-1276. https://doi.org/10.1176/appi.ps.201300383