Abstract

Physical restraint and seclusion have been well-known practices in medicine, and particularly in psychiatric settings worldwide. These controversial interventions should lead to Mental healthcare facilities to have a defined strategy to safely and effectively manage patients in high harm risk situations for him/herself and/or others, while ensuring the patients Human Rights, the United Nations Mental Illness Principles, and the torture prevention policies, aligned in a continuous patient’s safety and quality improvement culture of mental healthcare. This paper provides a practical succinct Harm Risk Situation management protocol applicable for most healthcare services, emphasizing the therapeutic aim of the sequenced staggered procedures empowering the verbal containment method, and strictly leaving involuntary pharmacological and physical containment as the last resource available, for the shortest time possible, and under constant qualified supervision.

Keywords: Agitation; Aggression; Restraint; Verbal de-escalation; Containment; Harm risk; Human rights

Abbreviations: HRS: Harm Risk Situations; MHF: Mental Health Facility; MI: Mental Illness; CT: Containment Team