WASHINGTON
(February 26, 1999) Expressing concern over
recent reports of death and injury from the use of
restraint and seclusion interventions with
psychiatric patients, the American Hospital
Association (AHA) and the National Association of
Psychiatric Health Systems (NAPHS) today issued Guiding
Principles on Restraint and Seclusion for Behavioral
Health Services.
These
principles are being distributed to members of both
NAPHS and the AHAs Section for Psychiatric and
Substance Abuse Services, and will be shared with
other constituencies working on the issue. The
statements are the first major initiative to result
from a Memorandum of Understanding (MOU) signed
between the NAPHS and AHA earlier this month. The MOU
provides an opportunity to focus on behavioral health
issues and collaborate in the areas of policy
development, information and data resources and
quality of care, among other activities.
"We
are very concerned about recent reports of injury and
death resulting from the use of restraint and
seclusion," said NAPHS Executive Director Mark
Covall. "We must ensure that patients are safe
and receive high-quality, individualized treatment.
These principles are designed to help behavioral
health organizations and providers review their
current policies and practices. The guiding
principles are also designed to provide a framework
to help legislative and regulatory bodies provide
appropriate oversight."
"Weve
drawn from existing principles and policies on
behavioral health that have long guided the field to
help develop these guidelines," said Jonathan T.
Lord, M.D., AHA chief operating officer.
"We
want to give this issue the attention it deserves,
and continue to help our members achieve the top
level of care that their patients expect."
Based on
expert practices, the principles identify seclusion
and restraint as emergency interventions which aim to
protect patients in danger of harming themselves or
others. When used properly, they can be life-saving
and injury-sparing interventions. However, both
organizations advocate using seclusion and restraint
as infrequently as possible, and only when less
restrictive methods are considered but are not
feasible.
In the
principles, the AHA and NAPHS acknowledge that
appropriate oversight of seclusion and restraint is
important, and commit to continuing to work with
consumers, families, regulatory and accrediting
agencies, Congress and others to ensure that the
systems are working, and that clear and appropriate
guidelines and standards are in place to protect
patients.
The AHA is
a not-for-profit association of health care provider
organizations and individuals that are committed to
the health improvement of their communities. The AHA
is the national advocate for its members, which
include 5,000 hospitals, health care systems,
networks, other providers of care and 37,000
individual members. Founded in 1898, the AHA provides
education for health care leaders and is a source of
information on health care issues and trends. For
more information, visit the AHA Web site at www.aha.org.
The
National Association of Psychiatric Health Systems
represents behavioral healthcare systems that are
committed to the delivery of responsive, accountable,
and clinically effective treatment and prevention
programs for people with mental and substance abuse
disorders. Its members are behavioral healthcare
provider organizations, including 400 specialty
hospitals, general hospital psychiatric and addiction
treatment units, residential treatment centers,
partial hospital services, behavioral group
practices, and other providers of care. NAPHS was
founded in 1933. For more information, visit the
NAPHS Web site at www.naphs.org.
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Editors
Note: Please call Dionne Dougall (AHA) or Carole
Szpak (NAPHS) for a copy of the guidelines.