Definitions of restraint

There is confusion surrounding the definition of restraint. The Oxford Dictionary 1993 defines restraint as “the deprivation or restriction of liberty or freedom of action or movement”. Duff et al 1996 reported there is no precise legal definition of restraint. In broad terms, it means restricting someone’s liberty or preventing them from doing something they want to do.

Others suggested that physical restraint refers to actions or procedures, which are designed to limit or suppress movement or mobility (Harris 1996) or defined as “an episode where staff had as part of clinical management, been required to lay hands on the patient without his or her consent” (Smith and Humphreys 1997).

The purpose of restraint is also viewed as “taking control of a dangerous situation and to limit the patient’s freedom for no longer than is necessary to end or significantly reduce the threat to himself or those around” (Mental Health Act Code of Practice (HMSO 1993). Harris J 1996 interjected that “physical restraint procedures were used for managing challenging behaviour presented by mentally retarded adults and children”, while Willis and LaVigna 1985 stated that it was “an emergency management procedure often used as a last resort”; Mcdonnell et al 1993 argued that “the aim primarily was to manage the violent individual and not to treat them”.

According to Bonner et al 2002, “control and restraint involves the use of techniques which endeavour to contain violent or potentially violent situations in a safe manner”. Harris and Rice 1986 referred to restraint as “the self-initiated application of manual physical control to a patient”. The Royal College of Psychiatrist (RCP 1998) indicated that “physical restraint should be a last resort, only being used in an emergency where there appears to be a real possibility of significant harm if withheld”. Lefensky et al 1978 and Harvey and Schepers 1977, simply mentioned that “arm locks were used to restrain people”. Interestingly most of the restraint definitions mentioned in this study sample tended to associate restraint with the management of violent situations, when violence is not the sole antecedent trigger for restraint applications.