Harm To Children Seen in Delay of Standards for Use of Seclusion and Restraint in Psychiatric Centers

Washington DC, March 21, 2001—Citing deaths of children from "unsafe restraint and seclusion practices" in psychiatric facilities, a coalition of national advocacy organizations reacted with "deep concern" to today's announcement of a delay in the effective date of federal rules setting standards for these practices.

The scheduled March 23 effective date for the protective rules was delayed under the Bush Administration's "regulatory review plan," postponing for 60 days all regulations published at the end of the Clinton Administration that do not "impact critical health and safety." The advocates assert that the rules limiting the use of seclusion and restraint on children "clearly meet this standard" and requested that the rules "go into effect as scheduled and without delay."

In a letter to White House Chief of Staff Andrew Card, the seven Washington-based organizations referenced a September 1999 report by the Government Accounting Office, "which found conclusively that children are especially targeted by facility staff for this unsafe practice, and are at greater risk of serious injury or death." The GAO had expressly called for regulations to address these concerns, the advocates said.

The letter attributed the delay to criticism by residential-care providers of the standards and the reporting requirements created by the new rule. For example, the rule bans the use of restraint and seclusion except to ensure the safety of the resident or others in an emergency situation, limits duration to from one to four hours, based on the child's age, requires a face-to-face medical assessment within the first hour, and mandates debriefing within 24 hours of all staff involved.

In a letter to the Administration expressing similar concerns, Connecticut Senators Christopher Dodd and Joseph Lieberman and Representative Rosa DeLauro cited the death last week of an 11-year-old as the result of "a misapplied restraint" in an Iowa facility as an example of the urgent need for regulations to take effect.

The groups forming the Advocacy Coalition for the Appropriate Use of Restraints are: The Arc of the United States, Bazelon Center for Mental Health Law, Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), Federation of Families for Children's Mental Health (FFCMH), National Alliance for the Mentally Ill (NAMI), National Association of Protection and Advocacy Systems (NAPAS), and National Mental Health Association (NMHA), and the International Association of Psycho-Social Rehabilitation Services (IAPSRS).

Contact information: Laurel Stine, 202-467-5730 ext. 134