National Technical Assistance Center


Creating Violence Free and Coercion Free Service Environments

For the Reduction of Seclusion and Restraint


Reducing Seclusion and Restraint Use in Mental Health Settings:
Deep Change Required¸

Setting the Stage




Anthony, W. A. (2004, Fall) Overcoming obstacles to a recovery-oriented system: The

necessity for state-level leadership. NASMHPD/NTAC e-Report on Recovery. Retrieved

November 28, 2004 from


D╠Orio, B.M., Purselle, D., Stevens, D., & Garlow, S.J. (2004). Reduction of episodes of

seclusion and restraint in a psychiatric emergency service. Psychiatric Services,

55, 581-583.


Duxbury, J. (2002). An evaluation of staff and patient views of and strategies employed to manage inpatient aggression and violence on one mental health unit: A pluralistic design. Journal of Psychiatric Mental Health Nursing, 9(3), 325-37.


Fisher, W. (1994). Restraint and seclusion: A review of the literature. American Journal of Psychiatry, 151, 1584-1591


Garbino, J. (1999). Lost boys: Why our sons turn violent and how we can save them. New York: Free Press.


Gilligan, J. and Lee, B. (2004). Beyond the Prison Paradigm: From Provoking Violence to Preventing It by Creating "Anti-Prisons" (Residential Colleges and Therapeutic Communities). Ann NY Acad Sci. 1036: 300-324.


Glover, R.W. (2005). Reducing the use of seclusion and restraint: A NASMHPD priority. Psychiatric Services, 56, 1141-1142.


Haney, C., Banks, C., & Zimbardo, P. (1973). Interpersonal dynamics in a simulated prison. International Journal of Criminology & Penology, 1(1), 69-97.


Health Care Financing Administration Interim Rules (1999). Medicare and Medicaid programs; Hospital conditions of participation: Patient╠s Rights. 42 CFR Part 482. Baltimore, MD: US Department of Health and Human Services. 


Hinsby, K. and Baker, M. (2004). Patient and Nurse Accounts of Violent Incidents in a Medium Secure Unit.  Journal of Psychiatric and Mental Health Nursing. 11, 241-247.


Institute of Medicine (IOM). (2001). Crossing the quality chasm: A New Health System for the 21st Century. Washington, DC: Institute of Medicine of the National Academies.


Institute of Medicine. (2005). Quality treatment for people with mental and substance-use disorders. Rockville, MD:  Institute of Medicine Academies Press


Kesey, K. (1962). One flew over the cuckoo╠s nest. New York: Signet


Mohr W. K., & Anderson, J. A. (2001). Faulty assumptions associated with the use of restraints with children. Journal of Child and Adolescent Psychiatric Nursing, 14, 141-151.


Morrison, E. F. (1989). The tradition of toughness: A study of nonprofessional nursing care in psychiatric nursing. Image: Journal of Nursing Scholarship, 22(1), 32-38.


NASMHPD, 2005/National Executive Training Institute (NETI). (2005). Training curriculum for reduction of seclusion and restraint. Draft curriculum manual. Alexandria, VA: National Association of State Mental Health Program Directors (NASMHPD), National Technical Assistance Center for State Mental Health Planning (NTAC).


Okin, R.L. (1985). Variation among state hospitals in use of seclusion and restraint.

Psychiatric Services, 36, 648-652.


Onken, S., Dumont, J., Ridgway, P., Dornan, D., & Ralph, R. (2002). Mental health recovery: What helps and what hinders? A nat ional research project for the development of recovery facilitating system performance indicators. Alexandria, VA: National Technical Assistance Center for State Mental Health Planning, National Association of State Mental Health Program Directors. 


Petti, T. A., Mohr, W., Somers, J. W., & Sims, L. (2001). Perceptions of seclusion and restraint by patients and staff in an intermediate-term care facility. Journal of Child and Adolescent Psychiatric Nursing, 14, 115-127


The President╠s New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final report. DHHS Pub. No. SMA-03-3832. Rockville, MD: U.S. Department of Health and Human Services.


Quinn, R. (1996). Deep change. San Francisco: Josey-Bass, Inc.


Robins, C.S., Sauvageot, J.A., Cusack, K.J., Suffoletta-Maierle, S., & Frueh, B. C.

(2005). Consumers╠ perceptions of negative experiences and ¤sanctuary harmË in

psychiatric settings. Psychiatric Services, 56, 1134-1138.


Rosenhan, D. (1973). On being sane in insane places. Science, 179, 250-258.


Ryan, E.P., Hart, V.S., Messick, D.L., Aaron, J., & Burnette, M. (2004). A prospective

study of assault against staff by youths in a state psychiatric hospital. Psychiatric Services, 55, 665-670.


Wiseman, F. (1967). Titicut follies. (unknown production company)