HOME

TheInfoList



OR:

Physical restraint refers to means of purposely limiting or obstructing the freedom of a person's bodily movement.


Basic methods

Usually, binding objects such as
handcuffs Handcuffs are Physical restraint, restraint devices designed to secure an individual's wrists in proximity to each other. They comprise two parts, linked together by a Link chain, chain, a hinge, or rigid bar. Each cuff has a rotating arm whi ...
,
legcuffs Legcuffs are physical restraints used on the ankles of a person to allow walking only with a restricted stride and to prevent running and effective physical resistance. Frequently used alternative terms are leg cuffs, (leg/ankle) shackles, foot ...
,
rope A rope is a group of yarns, plies, fibres, or strands that are twisted or braided together into a larger and stronger form. Ropes have tensile strength and so can be used for dragging and lifting. Rope is thicker and stronger than similarly ...
s,
chain A chain is a serial assembly of connected pieces, called links, typically made of metal, with an overall character similar to that of a rope in that it is flexible and curved in compression but linear, rigid, and load-bearing in tension. A c ...
s,
strap A strap, sometimes also called strop, is an elongated wikt:flap, flap or ribbon, usually of leather or other flexible materials. Thin straps are used as part of clothing or baggage, or bedding such as a sleeping bag. See for example spaghetti s ...
s or
straitjacket A straitjacket is a garment shaped like a jacket with long sleeves that surpass the tips of the wearer's fingers. Its most typical use is restraining people who may cause harm to themselves or others. Once the wearer slides their arms into the ...
s are used for this purpose. Alternatively different kinds of arm locks deriving from
unarmed combat Hand-to-hand combat (sometimes abbreviated as HTH or H2H) is a physical confrontation between two or more persons at short range (grappling distance or within the physical reach of a handheld weapon) that does not involve the use of weapons.Huns ...
methods or
martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defense; military and law enforcement applications; combat sport, competition; physical, mental, and spiritual development; entertainment; a ...
are frequently used to restrain a person, which are predominantly used by trained
police The police are a constituted body of persons empowered by a state, with the aim to enforce the law, to ensure the safety, health and possessions of citizens, and to prevent crime and civil disorder. Their lawful powers include arrest and t ...
or
correctional officer A prison officer or corrections officer is a uniformed law enforcement official responsible for the custody, supervision, safety, and regulation of prisoners. They are responsible for the care, custody, and control of individuals who have been ...
s. This less commonly also extends to joint locks and pinning techniques. The freedom of movement in terms of locomotion is usually limited, by locking a person into an enclosed space, such as a
prison cell A prison cell (also known as a jail cell) is a small room in a prison or police station where a prisoner is held. Cells greatly vary by their furnishings, hygienic services, and cleanliness, both across countries and based on the level of punish ...
and by chaining or binding someone to a heavy or immobile object. This effect can also be achieved by seizing and withholding specific items of clothing, that are normally used for protection against common adversities of the environment. Examples can be protective clothing against temperature, forcing the individual to remain in a sheltered spot. A practice employed in countries including Zimbabwe is to take away a prisoner's
shoes A shoe is an item of footwear intended to protect and comfort the human foot. They are often worn with a sock. Shoes are also used as an item of decoration and fashion. The design of shoes has varied enormously through time and from culture t ...
, forcing them to remain
barefoot Barefoot is the state of not wearing any footwear. There are health benefits and some risks associated with going barefoot. Shoes, while they offer protection, can limit the flexibility, strength, and mobility of the foot and can lead to ...
. The freedom of movement is practically restricted in many everyday situations without the protection offered by conventional
footwear Footwear refers to garments worn on the feet, which typically serves the purpose of protection against adversities of the environment such as wear from ground textures and temperature. Footwear in the manner of shoes therefore primarily serves th ...
. Controlling the free movement of detainees by keeping them barefoot is therefore common practice in many countries.


British police use

British Police
officers An officer is a person who has a position of authority in a hierarchical organization. The term derives from Old French ''oficier'' "officer, official" (early 14c., Modern French ''officier''), from Medieval Latin ''officiarius'' "an officer," f ...
are authorised to use leg and arm restraints, if they have been instructed in their use. Guidelines set out by the
Association of Chief Police Officers The Association of Chief Police Officers of England, Wales and Northern Ireland (ACPO) was a not-for-profit private limited company that for many years led the development of policing practices in England, Wales, and Northern Ireland. Established ...
dictate that restraints are only to be used on subjects who are violent while being transported, restraining the use of their arms and legs, minimising the risk of punching and kicking. Pouches carrying restraints are usually carried on the
duty belt A police duty belt (sometimes referred to as a gun belt, "duty rig" and/or kit belt) is a belt, typically constructed of nylon or leather used by police, prison and security officers to carry equipment easily in a series of pouches attached to ...
, and in some cases carried in
police van A police van (also known as a paddy wagon, meat wagon, divisional van, patrol van, patrol wagon, police wagon, Black Mariah/Maria, police carrier, or in old-fashioned usage, pie wagon) is a type of police vehicle, vehicle operated by Police, po ...
s.


Purpose

Physical restraints are used: * primarily by
police The police are a constituted body of persons empowered by a state, with the aim to enforce the law, to ensure the safety, health and possessions of citizens, and to prevent crime and civil disorder. Their lawful powers include arrest and t ...
and
prison A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, correc ...
authorities to obstruct delinquents and
prisoner A prisoner (also known as an inmate or detainee) is a person who is deprived of liberty against their will. This can be by confinement, captivity, or forcible restraint. The term applies particularly to serving a prison sentence in a prison. ...
s from escaping or resisting * to enforce corporal punishment (typically a form of
flagellation Flagellation (Latin , 'whip'), flogging or whipping is the act of beating the human body with special implements such as whips, rods, switches, the cat o' nine tails, the sjambok, the knout, etc. Typically, flogging has been imposed on ...
) by impeding motions of the target (usually prisoner), as is still practiced in penal functions of several countries * by specially-trained
teacher A teacher, also called a schoolteacher or formally an educator, is a person who helps students to acquire knowledge, competence, or virtue, via the practice of teaching. ''Informally'' the role of teacher may be taken on by anyone (e.g. whe ...
s or
teaching assistant A teaching assistant or teacher's aide (TA) or education assistant (EA) or team teacher (TT) is an individual who assists a teacher with instructional responsibilities. TAs include ''graduate teaching assistants'' (GTAs), who are graduate school ...
s to restrain children and teenagers with severe behavioral problems or disorders like
autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
or
Tourette syndrome Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) ...
, to prevent hurting others or themselves :# approximately 70% of teachers who work with students with behavioral disabilities use a type of physical restraint (Goldstein & Brooks, 2007) :# often used in emergency situations or for
de-escalation De-escalation is a human behavior that is intended to prevent escalation of conflicts. It may also refer to approaches in conflict resolution. People may become committed to behaviors that tend to escalate conflict, so specific measures must b ...
purposes (Ryan & Peterson, 2004) :# many educators believe restraints are used to maintain the safety and order of the classroom and students, while those who oppose their use believe they are dangerous to the physical and mental health of children and may result in death (McAfee, Schwilk & Miltruski, 2006) and (Kutz, 2009). :#
Individuals with Disabilities Education Act The Individuals with Disabilities Education Act (IDEA) is a piece of American legislation that ensures students with a disability are provided with a Free Appropriate Public Education (FAPE) that is tailored to their individual needs. IDEA was ...
has stated that "Restraints may not be used as an alternative to adequate staff" (McAfee, Schwilk & Miltruski, 2006, p. 713). Also, "restraint may be used only when aggressive behavior interferes with an individual's own ability to benefit from programming or poses physical threat to others" (McAfee, Schwilk & Miltruski, 2006, p. 713). * by
escapologist Escapology is the practice of escaping from restraints or other traps. Escapologists (also classified as escape artists) escape from handcuffs, straitjackets, cages, coffins, steel boxes, barrels, bags, burning buildings, fish-tanks, and oth ...
s,
illusionist Magic, which encompasses the subgenres of illusion, stage magic, and close up magic, among others, is a performing art in which audiences are entertained by tricks, effects, or illusions of seemingly impossible feats, using natural means. It ...
s and
stunt performer A stunt performer, often called a stuntman or stuntwoman and occasionally stuntperson or stunt-person, is a trained professional who performs daring acts, often as a career. Stunt performers usually appear in films or on television, as opposed ...
s * to restrain people who are suffering from involuntary physical spasms, to prevent them from hurting themselves (see
medical restraints Medical restraints are physical restraints used during certain medical procedures to restrain patients with (supposedly) the minimum of discomfort and pain and to prevent them from injuring themselves or others. Rationale There are many kinds of m ...
) * controversially, in
psychiatric hospital Psychiatric hospitals, also known as mental health hospitals, behavioral health hospitals, are hospitals or wards specializing in the treatment of severe mental disorders, such as schizophrenia, bipolar disorder, eating disorders, dissociative ...
s :# restraints were developed during the 1700s by
Philippe Pinel Philippe Pinel (; 20 April 1745 – 25 October 1826) was a French physician, precursor of psychiatry and incidentally a zoologist. He was instrumental in the development of a more humane psychological approach to the custody and care of ps ...
and performed with his assistant,
Jean-Baptiste Pussin Jean-Baptiste Pussin (1746–1811) was a hospital superintendent who, along with his wife and colleague Marguerite, established more humane treatment of patients with mental disorders in 19th-century France. They helped physician Philippe Pinel ap ...
in hospitals in France * by a
kidnap In criminal law, kidnapping is the unlawful confinement of a person against their will, often including transportation/asportation. The asportation and abduction element is typically but not necessarily conducted by means of force or fear: the p ...
per (stereotypically with rope or
duct tape Duct tape (also called duck tape, from the cotton duck cloth it was originally made of) is cloth- or scrim-backed pressure-sensitive tape, often coated with polyethylene. There are a variety of constructions using different backings and adhesi ...
and a
gag A gag is usually an item or device designed to prevent speech, often as a restraint device to stop the subject from calling for help and keep its wearer silent. This is usually done by blocking the mouth, partially or completely, or attemptin ...
) or other material * for
eroticism Eroticism () is a quality that causes sexual feelings, as well as a philosophical contemplation concerning the aesthetics of sexual desire, sensuality, and romantic love. That quality may be found in any form of artwork, including painting, sculp ...


Misuse and risks of physical restraints

Restraining someone against their will is generally a crime in most jurisdictions, unless it is explicitly sanctioned by law. (See
false arrest False arrest, Unlawful arrest or Wrongful arrest is a common law tort, where a plaintiff alleges they were held in custody without probable cause, or without an order issued by a court of competent jurisdiction. Although it is possible to sue ...
,
false imprisonment False imprisonment or unlawful imprisonment occurs when a person intentionally restricts another person’s movement within any area without legal authority, justification, or the restrained person's permission. Actual physical restraint is ...
). The misuse of physical restraint has resulted in many deaths. Physical restraint can be dangerous, sometimes in unexpected ways. Examples include: * postural asphyxia * unintended
strangulation Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging ...
* death due to
choking Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen dep ...
or
vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the Human nose, nose. Vomiting can be the result of ailments like Food-poisoning, foo ...
and being unable to clear the airway * death due to inability to escape in the event of fire or other disaster * death due to dehydration or starvation due to the inability to escape * cutting off of blood circulation by restraints * nerve damage by restraints * cutting of blood vessels by struggling against restraints, resulting in death by loss of blood * death by
hypothermia Hypothermia is defined as a body core temperature below in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe h ...
or
hyperthermia Hyperthermia, also known simply as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation. The person's body produces or absorbs more heat than it dissipates. When extreme ...
whilst unable to escape * death from
deep vein thrombosis Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enla ...
and
pulmonary embolism Pulmonary embolism (PE) is a blockage of an pulmonary artery, artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream (embolism). Symptoms of a PE may include dyspnea, shortness of breath, chest pain p ...
due to lack of movement For these and many other reasons, extreme caution is needed in the use of physical restraint.
Gag A gag is usually an item or device designed to prevent speech, often as a restraint device to stop the subject from calling for help and keep its wearer silent. This is usually done by blocking the mouth, partially or completely, or attemptin ...
ging a restrained person is highly risky, as it involves a substantial risk of
asphyxia Asphyxia or asphyxiation is a condition of deficient supply of oxygen to the body which arises from abnormal breathing. Asphyxia causes generalized hypoxia, which affects primarily the tissues and organs. There are many circumstances that can i ...
, both from the gag itself, and also from
choking Choking, also known as foreign body airway obstruction (FBAO), is a phenomenon that occurs when breathing is impeded by a blockage inside of the respiratory tract. An obstruction that prevents oxygen from entering the lungs results in oxygen dep ...
or
vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the Human nose, nose. Vomiting can be the result of ailments like Food-poisoning, foo ...
and being unable to clear the airway. In practice, simple gags do not restrict communication much; however, this means that gags that are effective enough to prevent communication are generally also potentially effective at restricting breathing. Gags that prevent communication may also prevent the communication of distress that might otherwise prevent injury.


Medical restraints

A survey in the US in 1998 reported an estimated 150 restraint related deaths in care environments (Weiss, 1998). Low frequency fatalities occur with some degree of regularity. An investigation of 45 restraint related deaths in US childcare settings showed 28 of these deaths were reported to have occurred in the prone position. In the UK restraint related deaths would appear to be reported less often. The evidence for effective staff training in the use of medical restraints is at best crude, with evaluation of training programmes being the exception rather than the rule. Vast numbers of care staff are trained in 'physical interventions' including physical restraint, although they rarely employ them in practice. It is accepted that staff training in physical interventions can increase carer confidence.


Japan

Japanese law states that psychiatric hospitals may use restraints on patients only if there is a danger that the patients will harm themselves. The law also states that a designated psychiatrist must approve the use of restraints and examine the patient at least every 12 hours to determine whether the situation has changed and the patient should be removed from restraints. However, in practice, Japanese psychiatric hospitals use restraints fairly often and for long periods. Despite being required to certify every 12 hours whether a patient still needs restraints, Japanese psychiatric hospitals keep patients in restraints for a much longer time than hospitals in other countries. According to a survey conducted on 689 patients in 11 psychiatric hospitals in Japan, the average time spent in physical restraints is 96 days. Meanwhile, the average time in most other developed countries is at most several hours to tens of hours. The number of people who are physically restrained in Japanese psychiatric hospitals continues to increase. In 2014 more than 10,000 people were restrained-the highest ever recorded, and more than double the number a decade earlier. It is thought that some of that increase includes older patients with dementia. As a result, the Japanese
Ministry of Health, Labour and Welfare The is a cabinet level ministry of the Japanese government. It is commonly known as in Japan. The ministry provides services on health, labour and welfare. It was formed with the merger of the former Ministry of Health and Welfare or and the ...
has revised its guidelines for elderly people in nursing homes to have more restrictions against body restraints. The changes will take effect on 1 April 2018. Deaths have been reported from their use.


United Kingdom

The Millfields Charter is an
electronic Electronic may refer to: *Electronics, the science of how to control electric energy in semiconductor * ''Electronics'' (magazine), a defunct American trade journal *Electronic storage, the storage of data using an electronic device *Electronic co ...
charter A charter is the grant of authority or rights, stating that the granter formally recognizes the prerogative of the recipient to exercise the rights specified. It is implicit that the granter retains superiority (or sovereignty), and that the rec ...
which promotes an end to the teaching to frontline healthcare staff of all prone (face down) restraint holds. In June 2013 the UK government announced that it was considering a ban on the use of face-down restraint in English mental health hospitals. Face down restraints are used more often on women and girls than on men. 51 out of 58 mental health trusts use restraints unnecessarily when other techniques would work. Organisations opposed to restraints include
Mind The mind is the set of faculties responsible for all mental phenomena. Often the term is also identified with the phenomena themselves. These faculties include thought, imagination, memory, will, and sensation. They are responsible for various m ...
and
Rethink Mental Illness Rethink Mental Illness is a mental health charity in England. The organisation was founded in 1972 by John Pringle whose son was diagnosed with schizophrenia. The operating name of 'Rethink' was adopted in 2002, and expanded to 'Rethink' Mental Il ...
. YoungMinds and Agenda claim restraints are "frightening and humiliating" and "re-traumatises" patients especially women and girls who have previously been victims of physical and/or sexual abuse. The charities sent an open letter to health secretary,
Jeremy Hunt Jeremy Richard Streynsham Hunt (born 1 November 1966) is a British politician who has served as Chancellor of the Exchequer since 14 October 2022. He previously served in the Cabinet as Secretary of State for Culture, Olympics, Media and Sport ...
showing evidence from 'Agenda, the alliance for women and girls at risk', revealing that patients are routinely restrained in some mental health units while others use non-physical ways to calm patients or stop self-harm. According to the letter over half of women with psychiatric problems have suffered abuse, restraint can cause physical harm, can frighten and humiliate the victim. Restraint, specially face down restraint can re-traumatise patients who previously suffered violence and abuse. "Mental health units are meant to be caring, therapeutic environments, for people feeling at their most vulnerable, not places where physical force is routine". Government guidelines state that face down restraint should not be used at all and other types of physical restraint are only for last resort. Research by Agenda found one fifth of women and girl patients in mental health units had suffered physical restraint. Some trusts averaged over twelve face down restraints per female patient. Over 6% of women, close to 2,000 were restrained face-down in total more than 4,000 times. The figures vary widely between regions. Some trusts hardly use restraints, others use them routinely. A woman patient was in several hospitals and units at times for a decade with mental health issues, she said in some units she suffered restraints two or three times daily. Katharine Sacks-Jones director of Agenda, maintains trusts use restraint when alternatives would work. Sacks-Jones maintains women her group speak to repeatedly describe face down restraint as a traumatic experience. On occasions male nurses have used it when a woman did not want her medication. "If you are a woman who has been sexually or physically abused, and mental health problems in women often have close links to violence and abuse, then a safer environment has to be just that: safe and not a re-traumatising experience. (...) Face-down restraint hurts, it is dangerous, and there are some big questions around why it is used more on women than men". The use of restraints in UK psychiatric facilities is increasing.


See also

*
Badge of shame A badge of shame, also a symbol of shame, a mark of shame or a stigma, is typically a distinctive symbol required to be worn by a specific group or an individual for the purpose of public humiliation, ostracism or persecution. The term is also u ...
*
Barefoot Barefoot is the state of not wearing any footwear. There are health benefits and some risks associated with going barefoot. Shoes, while they offer protection, can limit the flexibility, strength, and mobility of the foot and can lead to ...
* Corporal punishment * Detention *
Flagellation Flagellation (Latin , 'whip'), flogging or whipping is the act of beating the human body with special implements such as whips, rods, switches, the cat o' nine tails, the sjambok, the knout, etc. Typically, flogging has been imposed on ...
*
Handcuffs Handcuffs are Physical restraint, restraint devices designed to secure an individual's wrists in proximity to each other. They comprise two parts, linked together by a Link chain, chain, a hinge, or rigid bar. Each cuff has a rotating arm whi ...
*
Judicial corporal punishment The judiciary (also known as the judicial system, judicature, judicial branch, judiciative branch, and court or judiciary system) is the system of courts that adjudicates legal disputes/disagreements and interprets, defends, and applies the law ...
*
Legcuffs Legcuffs are physical restraints used on the ankles of a person to allow walking only with a restricted stride and to prevent running and effective physical resistance. Frequently used alternative terms are leg cuffs, (leg/ankle) shackles, foot ...
*
Pain compliance Pain compliance is the use of painful stimulus to control or direct an organism. The stimulus can be manual (brute force, placing pressure on painful areas, or use of painful hyperextension or hyperflexion on joints), use tools such as a whip or ...
* Pin-down scandal *
Prison A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, correc ...
*
Prison uniform A prison uniform is the standardized clothes worn by prisoners. It usually includes visually distinct clothes worn to indicate the wearer is a prisoner, in clear distinction from civil clothing. A prison uniform serves the purpose to make prison ...
*
Prisoner A prisoner (also known as an inmate or detainee) is a person who is deprived of liberty against their will. This can be by confinement, captivity, or forcible restraint. The term applies particularly to serving a prison sentence in a prison. ...
*
Prisoner abuse Prisoner abuse is the mistreatment of persons while they are under arrest or incarcerated. Prisoner abuse can include physical abuse, psychological abuse, sexual abuse, torture, or other acts such as refusal of essential medication. Physical ...
*
Public humiliation Public humiliation or public shaming is a form of punishment whose main feature is dishonoring or disgracing a person, usually an offender or a prisoner, especially in a public place. It was regularly used as a form of judicially sanctioned puni ...
*
Restraint chair A restraint chair is a type of physical restraint that is used to force an individual to remain seated in one place to prevent injury and harm to themselves or others. They are commonly used in prisons for violent inmates and hospitals for out of ...
*
Rope A rope is a group of yarns, plies, fibres, or strands that are twisted or braided together into a larger and stronger form. Ropes have tensile strength and so can be used for dragging and lifting. Rope is thicker and stronger than similarly ...
*
Strap A strap, sometimes also called strop, is an elongated wikt:flap, flap or ribbon, usually of leather or other flexible materials. Thin straps are used as part of clothing or baggage, or bedding such as a sleeping bag. See for example spaghetti s ...
* Strapping (punishment)


References


Sources

* * * * {{DEFAULTSORT:Physical Restraint