State considering new restraints for psychiatric patients

BOSTON (AP) – The state is considering new rules that would reduce how and when psychiatric patients can be restrained.

The new rules would require mental health facilities to train staff to intervene before a patients’ behavior becomes dangerous. Physical restraints, involving a patient being held or pinned by staff, as well mechanical restraints, including cuffs and sedatives, would become more regulated.

The proposals would, if adopted, allow patients to be restrained or secluded only in emergencies “such as the occurrence of, or serious threat of, extreme violence, personal injury, or attempted suicide.”

“The regulations in the past focused on a safe way to do a restraint. It implies restraints are the norm,” Dr. Elizabeth Childs, commissioner of the Department of Mental Health, told the Boston Herald. “These new regulations really speak to the fact that restraints aren’t the norm of treatment, they’re the exception.”

The proposed rule changes have the endorsement of advocates for psychiatric patients, and family members of people who have spent time in psychiatric wards.

“This is definitely the direction the mental health system needs to go in,” said Lisa Lambert of the Parent/Professional Advocacy League. “Everybody has a right to be in a safe environment.”

Jean Boursiquot’s 26-year-old son, James, a paranoid schizophrenic, died last August in restraints at Brockton Hospital’s psychiatric ward.

“I wish what my wife and I suffer, another family, another parent, won’t go through,” he said.

Charles Sarao of Haverhill said his 14-year-old son, Joshua, diagnosed with bipolar disorder, was punched in the face by staff at Westwood Lodge Hospital trying to restrain him. Sarao even went so far as to file a complaint with Westwood police.

A hospital spokeswoman said the incident never took place, but the state Department of Social Services is investigating the allegation, a spokeswoman confirmed.

While patient advocates and the families of patients endorse the proposed changes, psychiatric hospitals are concerned that the state is trying to micromanage them, said David Matteodo, executive director of the Massachusetts Association of Behavioral Health Systems.

“One hospital mentioned to me it may limit the kinds of patients they can take,” he said.

The proposals are part of a national trend aimed at reducing or eliminating the need for restraint, especially in children’s units. Cambridge Hospital has been recognized nationally for all but eliminating the use of restraints on children.

Staff members there are trained to intervene before a patient becomes self-destructive or dangerous, said Dr. Jay Berg, the hospital’s head of psychiatry.

-Associated Press