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Resource Document on the Use of Restraint and Seclusion in Correctional Mental Health Care

This Resource Document was produced by a workgroup of the American Psychiatric Association's Council on Psychiatry and Law, and reviewed and approved by the Council in September 2006. It was approved by the Joint Reference Committee of the American Psychiatric Association in December 2006. The findings, opinions, and conclusions of this report do not necessarily represent the views of the officers, trustees, or all members of the American Psychiatric Association. Views expressed are those of the authors. Address correspondence to: Jeffrey L. Metzner, MD, 3300 East First Ave., Suite 590, Denver, CO 80206. E-mail: jeffrey.metzner{at}uchsc.edu

This resource document discusses the use of seclusion or restraint for purposes of mental health intervention in correctional facilities. Correctional mental health standards essentially state that seclusion or restraint, when used for health care purposes, should be implemented in a manner consistent with current community practice. The community practice was significantly impacted and revised during July 1999, after the Health Care Financing Administration defined rules for the use of seclusion and restraint in facilities that participate in Medicare and Medicaid. Since few correctional facilities are Medicare or Medicaid participants, these rules had little impact on the use of seclusion or restraint for mental health care purposes in correctional systems. Consequently, many correctional health care systems have not developed policies, procedures, or practices that are consistent with current community practice. This document provides guidance in remedying such problems, with a focus on areas relevant to timeframes, settings, and monitoring.

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