Keeping patients out of restraints helped by use of private rooms

Psychiatric care teams in northeastern Ontario are looking at ways to keep people out of restraints.

How one northeastern Ontario hospital has been de-escalating patients without the use of restraints


Psychiatric care teams in northeastern Ontario are looking at ways to keep people out of restraints.

Restraints include things like seclusion rooms, strapping people to a bed, and injecting fast-acting drugs to sedate unruly people.

A manager at the Northeast Mental Health Centre in North Bay, said the need for crisis management has been curbed by having fewer dorm rooms.

"We have private rooms now, which is huge," Darla Bates said.

"When we were at the old site, we had dorms, and there were six patients to a dorm. And now everyone has their own private room. So, many times, when a patient is in crisis, they are able to go to their room rather than have us put them in a diversion room and they're able to de-escalate and have less stimuli in there."

From 2011 to 2014, restraint rates in her wing dropped from 79 incidents down to 25, she noted.

A study from the University of Waterloo , which was done between 2006 and 2010, said that hospitals use chairs that prevent rising, wrist restraints, seclusion rooms, and control medications.

Every single hospital in Ontario that had psychiatric patients was looked at for the study, which found one-in-four psychiatric patients in Ontario had been restrained.

The rate varied widely from hospital to hospital — from as few as eight per cent restrained, to as many as 36 per cent.

A Sudbury mental health group, Northern Initiative for Social Action, helps people with mental illness work through the lasting effects of being restrained.

"This is one of the extremes, where being in a closed room with the door closed is a problem," Shana Calixte said.

The use of restraints was the go-to solution for psychiatric patients years ago, Bates added.

"What I can tell you is that it was an everyday occurrence."

But in 2007, the hospital began training its staff to use restraint as the last option, she said.

"[Workers] spend quite a bit more time now verbally de-escalating a patient, rather than putting hands on a patient."