Mechanical Restraint in Inpatient Psychiatric Unit: Prevalence and Associated Clinical Variables

Background and Objectives: mechanical restraint (MR) is a controversial issue in emergency psychiatry and should be better studied to implement other alternative therapeutic interventions. The aim of this study was to estimate the prevalence of MR in an Italian psychiatric unit and identify the sociodemographic and clinical characteristics as well as the pharmacological pattern associated with MR. Materials and Methods: all subjects (N = 799) consecutively admitted to an Italian psychiatric inpatient unit were recruited. Several sociodemographic and clinical characteristics were recorded. Results: The prevalence of MR was 14.1%. Males, a younger age, and a single and migrant status were associated with the MR phenomenon. MR was more prevalent in patients affected by other diagnoses and comorbid illicit substance use, in patients with aggressive behaviors, and those that were involuntary admitted, leading significantly to hospitalization over 21 days. Furthermore, the patients that underwent MR were taking a lower number of psychiatric medications. Conclusions: Unfortunately, MR is still used in emergency psychiatry. Future research should focus on the dynamics of MR development in psychiatry, specifically considering ward- and staff-related factors that could help identify a more precise prevention and alternative intervention strategies.

Automated summary

This study aimed to estimate the prevalence of mechanical restraint (MR) in an Italian psychiatric unit and identify the associated characteristics. The results showed that MR was more prevalent among males, younger individuals, those who were single and migrants, as well as patients with other diagnoses, comorbid illicit substance use, aggressive behaviors, and involuntary admission. Additionally, patients who underwent MR were taking fewer psychiatric medications.