Containment practices in psychiatric care

This chapter explores containment practices in psychiatric settings, specifically focusing on research into these practices and the implications for care of patients in a range of inpatient settings. Acute inpatient units, aged-care psychiatry wards, and emergency departments are the main settings discussed in this chapter. Restraint here refers to any form of confinement of inpatients and includes physical, chemical, and environmental restraint, including locked ward doors and seclusion. Such restrictive measures remain controversial, albeit commonplace, and in contradiction to global policies about the need for humane and least restrictive care for people with a mental illness (United Nations 1991). These practices produce an uneasy dyad in which restraint is deemed an acceptable strategy to control patient behaviour, generally as a last resort, but as such lies in direct opposition to United Nations' principles on the protection of the mentally ill (United Nations 1991). The authors will discuss the prevalence of these intrusive and controlling practices, and the physical, social, and psychological consequences for patients subjected to them. In addition, we will explore the possibilities for care that improves patients' experiences of hospitalization and potential recovery from their illness.