NAMI Calls For Major Reforms In Use Of Physical Restraints In Psychiatric Facilities

Posted on October 16, 1998

Arlington, VA - In a move to stem a tide of death resulting from the inappropriate use of physical restraints in psychiatric facilities across the United States, the National Alliance for the Mentally Ill (NAMI) today called for an immediate federal investigation into the magnitude of this problem. Responding to a series of investigative reports published this week by The Hartford Courant, NAMI expressed its shock and outrage that authorities continue to look the other way when tragedy strikes individuals with serious mental illnesses, even when so clear a pattern of abuse exists.

A 50-state survey conducted by the Hartford, Connecticut newspaper, revealed at least 142 deaths in the past decade connected to the use of physical restraints or the practice of seclusion. The news report also suggested that the actual number of deaths is many times higher because many such deaths go unreported. According to a separate statistical estimate commissioned by The Courantand conducted by the Harvard Center for Risk Analysis, between 50 and 150 such deaths occur every year across the country.

“As individuals who have personally experienced the neglect and complacency of a healthcare system that frequently disregards the needs of extremely vulnerable individuals, we grieve deeply for all those who have lost their lives from abusive treatment. We also grieve for their families,” said NAMI Executive Director Laurie Flynn. “The real tragedy of this report is that steps have not been taken to prevent future deaths.”

In order to remedy this situation, NAMI believes that the following steps must be taken:

• Independent, third-party entities should be established to conduct thorough and immediate investigations into all deaths and serious injuries which occur during psychiatric treatment. When necessary, these entities should be vested with the authority to recommend and institute changes and practices to prevent future abuses.
• The U.S. Department of Justice and the U.S. Department of Health and Human Services should launch a thorough national investigation to determine the magnitude of abusive and harmful seclusion and restraint practices in psychiatric treatment facilities and programs throughout the country.
• States should adopt laws authorizing the establishment of third-party independent monitoring groups to conduct unannounced inspections of psychiatric facilities. Active participation by consumers and family members should be required.
• States should allocate funds for the expressed purpose of training individuals who work with psychiatric patients on the appropriate use of physical restraints.
• National standards on the appropriate use of restraints representing best clinical practices should be developed and enforced by the Health Care Finance Administration. Commercial insurance payors should adopt these HCFA standards to apply to private-pay patients.

“We are very grateful to the Hartford Courant for their courageous leadership in exposing this crisis to the nation,” said Laurie Flynn. “NAMI intends to use this report to push for reforms which will ensure that people with mental illnesses are treated with the dignity and respect they deserve.”