Risk Factors for Seclusion and Restraint in a Pediatric Psychiatry Day Hospital

Wuroh Timbo; Aishwarya Sriram; Elizabeth K Reynolds; Renee DeBoard-Lucas; Matthew Specht; Carolyn Howell; Colleen McSweeney; Marco A Grados

doi:10.1007/s10578-015-0608-1

Risk Factors for Seclusion and Restraint in a Pediatric Psychiatry Day Hospital

Child Psychiatry Hum Dev. 2016 Oct;47(5):771-9. doi: 10.1007/s10578-015-0608-1.

Authors

Wuroh Timbo¹, Aishwarya Sriram², Elizabeth K Reynolds¹, Renee DeBoard-Lucas³, Matthew Specht¹, Carolyn Howell¹, Colleen McSweeney⁴, Marco A Grados⁵

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA.
² Johns Hopkins University, Baltimore, MD, USA.
³ Johns Hopkins Hospital, Baltimore, MD, USA.
⁴ Susquehanna University, Selinsgrove, PA, USA.
⁵ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St., 12th Floor, Baltimore, MD, 21287, USA. [email protected].

PMID: 26643416
DOI: 10.1007/s10578-015-0608-1

Abstract

The use of seclusion and restraints (SR) in acute hospital settings remains a controversial practice. Despite the focus on SR in the psychiatric services literature, data on SR use in pediatric day hospital settings is lacking. A case-control retrospective analysis for children admitted into a pediatric psychiatry day hospital in a 2-year span examined predictors of SR use. Demographic and clinical descriptors were examined in relation to SR events using univariate and multivariate regression models. Significant univariate risk factors for SR use were psychiatric morbidity, history of physical abuse, post-traumatic stress disorder, having any anxiety disorder, and younger age. Knowledge of risk factors for SR use in pediatric psychiatric day hospitals can avert use of SR and lead to improved safety in a trauma-informed care model.

Keywords: Abuse; Pediatric; Restraint; Seclusion; Trauma.

MeSH terms

Child
Day Care, Medical* / methods
Day Care, Medical* / statistics & numerical data
Female
Hospitals, Pediatric / statistics & numerical data
Hospitals, Psychiatric / statistics & numerical data
Humans
Male
Mental Disorders* / epidemiology
Mental Disorders* / psychology
Mental Disorders* / therapy
Patient Isolation* / methods
Patient Isolation* / psychology
Psychiatry / methods
Restraint, Physical* / adverse effects
Restraint, Physical* / psychology
Retrospective Studies
Risk Factors
United States / epidemiology