Mental Health:

Extent of Risk From Improper Restraint or Seclusion Is Unknown

T-HEHS-00-26: Published: Oct 26, 1999. Publicly Released: Oct 26, 1999.

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William J. Scanlon
(202) 512-7114


Office of Public Affairs
(202) 512-4800

Pursuant to a congressional request, GAO discussed the effect of improper restraint and seclusion on some of the country's most vulnerable citizens--people with serious mental illness or mental retardation.

GAO noted that: (1) as GAO recently reported, improper restraint and seclusion can be dangerous to people receiving treatment for mental illness or mental retardation and to staff in treatment facilities; (2) while there is no comprehensive system to track injuries or deaths, GAO found that at least 24 deaths that state protection and advocacy agencies (P&A) investigated in fiscal year 1998 were associated with the use of restraint or seclusion; (3) GAO believes there may have been more deaths because only 15 states require any systematic reporting to P&As to alert them to serious injuries and deaths; (4) GAO also found that federal and state regulations that govern the reporting of injuries and deaths and that govern the use of restraint and seclusions are not consistent for different types of facilities; (5) the experience of several states demonstrates that having regulatory protections and reporting requirements can reduce the use of restraint and seclusion and improve safety for individuals receiving treatment as well as for facility staff; and (6) in GAO's September 1999 report, GAO made several recommendations that, if adopted, should improve the safety of patients and staff in a variety of treatment settings.

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