Alternatives to Seclusion and Restraint

SAMHSA is committed to eliminating the use of seclusion and restraint in the treatment of people with mental and/or substance use disorders.

Seclusion and restraint were once perceived as therapeutic practices in the treatment of people with mental and/or substance use disorders. Today, these methods are viewed as traumatizing practices and are only to be used as a last resort when less-restrictive measures have failed and safety is at severe risk.

Seclusion is defined as the involuntary, solitary confinement of an individual. Restraint refers to any method, physical or mechanical device, or material or equipment that immobilizes or reduces an individual’s ability to freely move his or her arms, legs, body, or head. A drug or medication also might be used to restrict behavior or freedom of movement.

Studies have shown that the use of seclusion and restraint can result in psychological harm, physical injuries, and death to both the people subjected to and the staff applying these techniques. Injury rates to staff in mental health settings that use seclusion and restraint have been found to be higher than injuries sustained by workers in high-risk industries. Restraints can be harmful and often re-traumatizing for people, especially those who have trauma histories.

Beyond the physical risks of injury and death, it has been found that people who experience seclusion and restraint remain in care longer and are more likely to be readmitted for care.

SAMHSA is committed to reducing and ultimately eliminating the use of seclusion and restraint practices in organizations and systems serving people with mental and/or substance use disorders. SAMHSA’s goal is to create coercion- and violence-free treatment environments governed by a philosophy of recovery, resiliency, and wellness. Successful efforts have eliminated these practices in psychiatric hospitals, forensic psychiatric settings, therapeutic schools, residential treatment centers, and jails and criminal justice settings.

Learn about these safe, effective alternatives to seclusion and restraint in the following resources:

Last Updated: 09/16/2015