Restraint and Seclusions
Resources

More training and technical assistance materials for P&As/CAPs available in password-protected TASC section. If you do not have a username and password, please contact your Executive Director or webmaster@ndrn.org.

Page last updated: 06/25/08

Assumptions

Current Assumptions regarding Seclusion and Restraint Use, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference (Powerpoint Presentation) (References)

Autism

Michigan Autism Society v. Fuller – Complaint filed by Michigan Protection and Advocacy, Inc. on behalf of Michigan Autism Society (May 2, 2005) (declaratory and injunctive relief to prevent inappropriate restraint and seclusion in Michigan school district)

Brochures and Training Tools for P&As

Roadmap to Seclusion and restraint Free Mental Health Services, publised by the U.S. Department of health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (2006). Training Manual to increase the knowledge of mental health service direct care staff, administrators, and consumers on alternatives to the use seclusion and restraint.
http://www.mentalhealth.samhsa.gov/publications/allpubs/sma06-4055/

Sample Rights Brochures on Seclusion and Restraint (Dec 2005)

Comfort Rooms:

Comfort Rooms: Reducing the Need for Seclusion and Restraint, by Gayle Bluebird Residential Group Home Quarterly Vol 5 No 4, P5 (Spring 2005)

Deaf/Hard of Hearing

Reducing the Use of Seclusion and Restraint (Part III): Lessons from the Deaf and Hard of Hearing Communities, prepared by the National Association of State Mental Health Program Directors

Debriefing

Restraint and Seclusion Patient Debriefing Form ( Iowa Mental Health Institute, Independence Iowa) (Feb 2005)

Developmental disabilities, individuals with

Reducing the Use of Seclusion and Restraint Part II: Findings, Principles and Recommendations for Special Needs Populations, prepared by the National Association of State Mental Health Program Directors (March 2001)

Evidence Based Practices

Evidenced-Based Practices Goran Jovanovic and Matthew Johnsen, Restraint and Seclusion: can they become obsolete Practices, Center for mental Health Services Research, vol 3, issue 2 (Feb. 2006) (discuss research about what strategies effectively reduce restraint and seclusion)

Government Accounting Office (GAO) Reports

Improper Restraint and Seclusion Use Places People at risk – The GAO's October 1, 1999 report confirms that there is no adequate system of restraint and seclusion (R/S) reporting at the state level, making it impossible to determine the true level of deaths and injuries that result from R/S abuses and preventing independent agency investigations.  GAO calls on CMS to issue regulations which: (1) establish strict standards on the use of R/S in all facilities which receive Medicaid and Medicare, and (2) require reporting to P&As regarding all deaths and serious injuries among those with mental illness or mental retardation indicating whether R/S was used -- for investigation by P&As. (10/5/99) PDF

Hartford Current articles

A Five-Part Series published in The Hartford Courant, beginning on October 11, 1998. Go to: http://www.charlydmiller.com/LIB05/1998hartfordcourant11.html

Leadership

Leadership towards Organizational Change, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference (references)

Medical Risks

Restraint and Seclusion: A Risk Management Guide, by Stephen Haimowitz, J.D., Jenifer Urff, J.D. and Kevin Ann Huckshorn R.N. M.S.N. CAP, ICADC (Sept 2006)

The Lethal Hazard of Prone Restraint: Positional Asphyxiation, prepared by Protection and Advocacy, Inc (CA P&A)(April 2002)

In the matter of Neil Larkin: A case study on restraint, Traumatic Asphyxia and Investigations by New York Commission on Quality Care and Advocacy for Persons with Disabilities (NY P&A) (good discussion of dangers of prone restraint)

Organizations working on reduction of seclusion and restraint

A.P.R.A.I.S. The Allliance to Prevent Restraint, Aversive Interventions, and Seclusion, www.aprais.org

The Alliance to Prevent Restraint, Aversive Interventions, and Seclusion was founded in April 2004 by members of the nation's leading education, research and advocacy organizations to protect children from abuse in their schools, treatment programs, and residential facilities. APRAIS is responding passionately to the increasing toll of deaths, injuries, and trauma resulting from the use of inhumane practices in programs serving children and youth with disabilities.

Center for Public Representation, www.centerforpublicrep.org

The Center for Public Representation is organized as a self-sufficient public interest law firm to promote change in the quality of lives of individuals with disabilities in Massachusetts and to pursue the systemic enforcement of legal rights on a statewide and national basis. The Center's primary purpose is to serve people who have or are considered to have disabilities. The Center also may assist, to a limited extent, other people who are institutionalized, discriminated against, or otherwise denied fundamental human rights.

Child Welfare League of America, www.cwla.org

The Child Welfare League of America is the nation’s oldest and largest membership-based child welfare organization. It is committed to engaging people everywhere in promoting the well-being of children, youth and their families and protecting every child from harm.

Judge David L. Bazelon Center for Mental Health Law, www.bazelon.org

For three decades, the Judge David L. Bazelon Center for Mental Health Law has been the nation's leading legal advocate for people with mental disabilities. Our precedent-setting litigation has outlawed institutional abuse and won protections against arbitrary confinement. In the courts and in Congress, our advocacy has opened up public schools, workplaces, housing and other opportunities for people with mental disabilities to participate in community life.

NAMI, www.nami.org

NAMI (the National Alliance on Mental Illness) is the nation’s largest grassroots mental health organization dedicated to improving the lives of persons living with serious mental illness and their families. Founded in 1979, NAMI has become the nation’s voice on mental illness, a national organization including NAMI organizations in every state and in over 1100 local communities across the country who join together to meet the NAMI mission through advocacy, research, support, and education.

National Association of State Mental Health Program Directors (NASHMPD), www.nasmhpd.org

Founded in 1959 and based in Alexandria, VA, the National Association of State Mental Health Program Directors (NASMHPD) represents the $23 billion public mental health service delivery system serving 6.1 million people annually in all 50 states, 4 territories, and the District of Columbia. NASMHPD (pronounced “NASH-bid”) operates under a cooperative agreement with the National Governors Association and is the only national association to represent state mental health commissioners/directors and their agencies.

TASH, www.tash.org

TASH is an international association of people with disabilities, their family members, other advocates, and professionals fighting for a society in which inclusion of all people in all aspects of society is the norm.

Neurobiological and Psychological Effects

The Neurobiogical and Psychological Effects of Trauma, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference ( Powerpoint Presentation) ( References)

P&A Priorities

Sample Seclusion and Restraint Reduction Priorities of P&As (Dec 2005)

Model Seclusion and Restraint Reduction Priority (Dec. 2005)

Prevention Tools

Seclusion and Restraint Prevention Tools, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference ( Powerpoint Presentation) ( References)

Prone Restraints

The Lethal Hazard of Prone Restraint: Positional Asphyxiation, prepared by Protection and Advocacy, Inc (CA P&A)(April 2002)

In the matter of Neil Larkin: A case study on restraint, Traumatic Asphyxia and Investigations by New York Commission on Quality Care and Advocacy for Persons with Disabilities (NY P&A) (good discussion of dangers of prone restraint)

Schools

Colorado Public Report of an Investigation into the Improper Use of Restraint and Seclusion of Students with Disabilities at Will Rogers Elementary School, prepared by  (March 9, 2007)

Connecticut – An Act Concerning Restraints and Seclusion in Public Schools (eff. 10/1/07)

Massachusetts Department of Education Regulations on the Use of Restraint in Public Schools – provides a detailed approach to limiting use of restraints

Restraint and Seclusion in California Schools – A Failing Grade, produced by Protection and Advocacy, Inc. (California P&A) (June 2007)

(Wisconsin) Guidelines for the Appropriate Use of Seclusion and Restraint in pecial Education Programs, prepared by Wisconsin Department of Public Instruction (Sept. 2005)

Standing

Autism Society of Michigan and Michigan Protection and Advocacy Services, Inc. v. Fuller, No 5:05-CV-73 (W.D. Mich. May 26, 2006) (plaintiffs sought declaratory and injunctive relief for purpose of getting school officials to establish seclusion and restraint policies and to train staff - dismissed for lack of standing)

State Incentive Grants

SAMSHA Notice of Funding Availability (June 1, 2004)

Inventory of Seclusion and Restraint Reduction Interventions

 

State Statutes and Policies - Models

Selected State R&S laws (July 2006)

Iowa Mental Health Institute – Independence, IA.

Restraint and Seclusion Policy (Feb 2005)

(Patient) Information to Help Avoid Restraint/Seclusion: Risks, Triggers, Signs and Coping Aids

Restraint or Seclusion Prescription

Restraint and Seclusion (monitoring) Checklist and Narrative

Restraint and Seclusion Patient Debriefing Form

Restraint and Seclusion – Same Day Staff Analysis

Restraint and Seclusion Debriefing Form – Next Working Day Team Analysis

Trauma Informed Care

Trauma Informed Care, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference ( powerpoint)( references)

Traumatic Brain Injuries

Reducing the use of Restraint of Individuals Traumatic Brain Injury, by the Health Resources and Services Administration Federal TBI Program Webcast (July 27, 2006)

Transport

Vermont Passes Law Prohibiting Transport of Children in Shackles (June 2006) - The new law (H.306)--which covers the transport of pregnant woman in correctional settings, individuals residing in inpatient settings, and children within the jurisdiction of the state department of children and families -- generally establishes a policy disfavoring the use of restraint during transport and requires state officials to ensure that transport is done in a manner which prevents physical and psychological trauma, respects the privacy of the individual, and represents the least restrictive means necessary for the safety of the individual. The law also requires significant documentation and data collection about restraint use during transport.