Summary Report May 2003 - A National Call to Action:
Eliminating the Use of Seclusion and Restraint

Launching the Call to Action

Consumer advocate Laura Prescott suggested that in spite of many barriers, many reasons exist to persist in the vision of a better future, where seclusion and restraint are things of the past and nonviolence is embraced. Each step that is taken collectively widens the path for others to follow. So much has been achieved over the last few years, but more is needed to succeed in the commitment to end seclusion and restraint. The existence of seclusion and restraint sends an important message to staff, the public, and that people with mental illness are dangerous, and it is time to deliver a new message.

The words used to describe the use of force in facilities are similar to those used to describe a war. Seclusion and restraint are practices of aggression and force, implying that psychiatric facilities are dangerous places where clinical staff are soldiers battling an enemy. As long as the myth of danger persists, people will continue to justify the use of force and aggression in the interest of public safety.

The challenge continues to be a culture in which people believe that restraint helps maintain control and that seclusion provides an opportunity to destimulate. The assumption of therapeutic benefit persists, but many other ways exist to achieve these ends. Restraint and seclusion are interventions of control and treatment failure.

A different future can be created, but this will require leadership commitment. It is time to shift the focus from deficit-based models to a strength-based orientation to improve the overall quality of care. Psychiatric, criminal, and other systems have accomplished dramatic reductions in the use of seclusion and restraint when administrators, staff, consumers, and advocates work together.

The opportunity exists to embrace a new history and to become leaders. Those in the mental health field must begin to insist that the business of mental health protects and defends human dignity and autonomy, because each life lost diminishes everyone.