Professional containment methods used in psychiatry wards: justi fications for their utilization, types, international practices, and perceptions

Abstract

Objective: The aim of this review is to examine the literature on professional containment methods, to draw attention to this important topic concerning which relevant research remains limited in our country and to offer professionals the opportunity to make evaluations utilizing holistic perspectives. Method: Relevant, obtainable studies published within the last 15 years, but primarily after the year 2000, were included in this retrospective literature review. For this purpose a literature search was conducted via-internet based search engines, including Pubmed, Science Direct, Medline, Psychinfo, the ULAKBİM Turkish Medicine Index and the Turkish Psychiatry Index, using the keywords containment methods, psychiatry, aggression, conflict, restraint, seclusion and mental health hospitals, in different combinations. Results: According to the literature, professional containment methods are defined as methods used to prevent harm to patients or others as a result of the patient's conflict-provoking behaviour (agression, absconding, rule breaking, refusing medication etc.) in psychiatric wards. These methods include the use of mechanical/physical restraint, seclusion, compulsory intramuscular sedation, observation, and pro re nata (prn) medication. The type and frequency of use, views or attitudes to methods varies between different countries. Conclusion: Although professional containment methods are an effective management strategy, they may cause physical and psychological damage to both patient and staff. So the use of these methods in psychiatric care settings remains controversial and an ongoing source of legal and ethical dilemmas. Despite discussions, the containment methods used in the past remain present as a part of psychiatric treatment and care. There is a need for standard practice guidelines to ensure the security of patients and staff and to use those methods effectively and correctly. In conclusion, it is necessary that health care professionals be informed about preparing the new guidelines and using professional containment methods effectively.