Morbidity and mortality associated with the utilization of restraints : a review of literature

Psychiatr Q. 2013 Dec;84(4):499-512. doi: 10.1007/s11126-013-9262-6.


Use of physical restraints remains a highly controversial topic. Even with proven efficacy in restraint usage across multiple settings, for years, investigators have debated whether or not the risks outweigh the benefits. There is a growing concern regarding restraints-related negative consequences. Although over the past two decades, with new regulations, education and training, there has been a reduction in the prevalence of restraint episodes, morbidity and mortality are still disconcerting. Given this subject remains an issue today, a more up-to-date review of available literature is warranted. This article reviews the current literature surrounding the utilization of restraints that has been published over last 10 years with particular emphasis on restraints-related adverse outcomes. The vast amount of literature during the past decade demonstrates an increased awareness in potential dangers, as well as highlights new areas of research in restraint utilization. Despite the proliferation of studies, there continues to remain a lack of evidence from prospective studies that would elucidate the dangers from theory to practice.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel
  • Cause of Death
  • Humans
  • Mental Disorders / therapy*
  • Mentally Ill Persons / psychology
  • Morbidity
  • Mortality*
  • Prevalence
  • Restraint, Physical* / adverse effects
  • Restraint, Physical* / psychology
  • Restraint, Physical* / standards
  • Restraint, Physical* / statistics & numerical data
  • Risk Factors
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / etiology