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Home Issues Abuse and Neglect Restraint and Seclusion

Our Position

angie"Angie, age 7, suffocated while being restrained"

Whenever we open a newspaper, turn on the television, or go on the Internet these days, we hear about another child dying or being injured in school while being restrained or secluded. Some may think these are isolated incidents, but, when P&A agencies across this country report that school children have been killed, confined, tied up, pinned down, and battered, this is clearly more than an isolated issue - it is one of national concern.Swift action to ban the use of prone restraint and seclusion in schools, and increased teacher training will eliminate unintentional tragedies. It is the hope of the National Disability Rights Network that calling attention to this pervasive problem will spur action on the local, state, and national levels to address this crisis immediately.


Taking Action

Capitol_BuildingAction Alert: Ask Congress to Cosponsor Restraint/Seclusion Bills!

Email your two Senators and Congresstional Representative and ask them to cosponsor the Keeping all Students Safe Act (S. 2020 & H.R. 1381).  Click here for more details.

In 2008, NDRN launched a major investigation into the abusive use of restraint and seclusion on school children in our nation's public schools.  What we found shocked us and the nation and was the catalyst for a Congressional investigation and legislation introduced to stop the practice.  Read below the findings of our investigation.

School_is_Not_Supposed_to_Hurt_3_coverMarch, 2012

School is Not Supposed to Hurt: The U.S. Department of Education Must Do More to Protect School Children from Restraint and Seclusion

Recommendations to the Department of Education to reduce and prevent the use of restraint and seclusion on school children.

NDRN_School_Cover_2010_thumbJanuary 2010

School Is Not Supposed to Hurt: Update on Progress in 2009

In these pages lies the culmination of a year of intense advocacy work, family support, and initial action of lawmakers to regulate restraint and seclusion in schools.

school_not_hurt2009January, 2009

School Is Not Supposed to Hurt: Investigative Report on Abusive Restraint and Seclusion in Schools

Whenever we open a newspaper, turn on the television, or go on the Internet these days, we hear about another child dying or being injured in school while being restrained or secluded. Some may think these are isolated incidents, but, when Protection and Advocacy (P&A) agencies across this country report that school children have been killed, confined, tied up, pinned down, and battered, this is clearly more than an isolated issue - it is one of national concern.


Resources

Learn more about Federal Statutes and Regulations affecting the use of restraint and seclusion.

Assumptions

Current Assumptions regarding Seclusion and Restraint Use, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference (Powerpoint Presentation ) (References )

Autism

Michigan Autism Society v. Fuller – Complaint filed by Michigan Protection and Advocacy, Inc. on behalf of Michigan Autism Society (May 2, 2005) (declaratory and injunctive relief to prevent inappropriate restraint and seclusion in Michigan school district)

Brochures and Training Tools for P&As

Roadmap to Seclusion and restraint Free Mental Health Services, publised by the U.S. Department of health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services (2006). Training Manual to increase the knowledge of mental health service direct care staff, administrators, and consumers on alternatives to the use seclusion and restraint.
http://www.mentalhealth.samhsa.gov/publications/allpubs/sma06-4055/

Comfort Rooms:

Comfort Rooms: Reducing the Need for Seclusion and Restraint, by Gayle Bluebird Residential Group Home Quarterly Vol 5 No 4, P5 (Spring 2005)

Deaf/Hard of Hearing

Reducing the Use of Seclusion and Restraint (Part III): Lessons from the Deaf and Hard of Hearing Communities, prepared by the National Association of State Mental Health Program Directors

Debriefing

Restraint and Seclusion Patient Debriefing Form ( Iowa Mental Health Institute, Independence Iowa) (Feb 2005)

Developmental disabilities, individuals with

Reducing the Use of Seclusion and Restraint Part II: Findings, Principles and Recommendations for Special Needs Populations, prepared by the National Association of State Mental Health Program Directors (March 2001)

Evidence Based Practices

Evidenced-Based Practices Goran Jovanovic and Matthew Johnsen, Restraint and Seclusion: can they become obsolete Practices, Center for mental Health Services Research, vol 3, issue 2 (Feb. 2006) (discuss research about what strategies effectively reduce restraint and seclusion)

Government Accounting Office (GAO) Reports

Improper Restraint and Seclusion Use Places People at risk – The GAO's October 1, 1999 report confirms that there is no adequate system of restraint and seclusion (R/S) reporting at the state level, making it impossible to determine the true level of deaths and injuries that result from R/S abuses and preventing independent agency investigations.  GAO calls on CMS to issue regulations which: (1) establish strict standards on the use of R/S in all facilities which receive Medicaid and Medicare, and (2) require reporting to P&As regarding all deaths and serious injuries among those with mental illness or mental retardation indicating whether R/S was used -- for investigation by P&As. (10/5/99) PDF

Hartford Current articles

A Five-Part Series published in The Hartford Courant, beginning on October 11, 1998. Go to: http://www.charlydmiller.com/LIB05/1998hartfordcourant11.html

Leadership

Leadership towards Organizational Change, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference (references)

Medical Risks

Restraint and Seclusion: A Risk Management Guide, by Stephen Haimowitz, J.D., Jenifer Urff, J.D. and Kevin Ann Huckshorn R.N. M.S.N. CAP, ICADC (Sept 2006)

The Lethal Hazard of Prone Restraint: Positional Asphyxiation , prepared by Protection and Advocacy, Inc (CA P&A)(April 2002)

In the matter of Neil Larkin: A case study on restraint, Traumatic Asphyxia and Investigations by New York Commission on Quality Care and Advocacy for Persons with Disabilities (NY P&A) (good discussion of dangers of prone restraint)

Neurobiological and Psychological Effects

The Neurobiogical and Psychological Effects of Trauma, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference  ( References)

P&A Priorities

Sample Seclusion and Restraint Reduction Priorities of P&As (Dec 2005)

Model Seclusion and Restraint Reduction Priority (Dec. 2005)

Prevention Tools

Seclusion and Restraint Prevention Tools, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference  (References )

Prone Restraints

The Lethal Hazard of Prone Restraint: Positional Asphyxiation, prepared by Protection and Advocacy, Inc (CA P&A)(April 2002)

Schools

Abuse and Neglect of Children with Disabilities in NY Non-Residential Schools, published by Disabled Abuse Coalition (April 2009)

Reduce Your Risk: Evidence-based Practices to Prevent Harmful Student Restraint and Seclusion, LRP Publications Audio Conference (April 7, 2009)

Use of Seclusion, Restraints on Students at Issue (Education Week)(April 2009)

Use of Restraint and Seclusion in Public Schools – Guiding Principles (NDRN)

Colorado Public Report of an Investigation into the Improper Use of Restraint and Seclusion of Students with Disabilities at Will Rogers Elementary School, prepared by  (March 9, 2007)

Connecticut – An Act Concerning Restraints and Seclusion in Public Schools (eff. 10/1/07)

Massachusetts Department of Education Regulations on the Use of Restraint in Public Schools – provides a detailed approach to limiting use of restraints

Restraint and Seclusion in California Schools – A Failing Grade, produced by Protection and Advocacy, Inc. (California P&A) (June 2007)

(Wisconsin) Guidelines for the Appropriate Use of Seclusion and Restraint in pecial Education Programs, prepared by Wisconsin Department of Public Instruction (Sept. 2005)

Standing

Autism Society of Michigan and Michigan Protection and Advocacy Services, Inc. v. Fuller, No 5:05-CV-73 (W.D. Mich. May 26, 2006) (plaintiffs sought declaratory and injunctive relief for purpose of getting school officials to establish seclusion and restraint policies and to train staff - dismissed for lack of standing)

State Incentive Grants

Inventory of Seclusion and Restraint Reduction Interventions

State Statutes and Policies - Models

Selected State R&S laws (July 2006)

Iowa Mental Health Institute – Independence, IA.

Restraint and Seclusion Policy (Feb 2005)

(Patient) Information to Help Avoid Restraint/Seclusion: Risks, Triggers, Signs and Coping Aids

Restraint or Seclusion Prescription

Restraint and Seclusion (monitoring) Checklist and Narrative

Restraint and Seclusion Patient Debriefing Form

Restraint and Seclusion – Same Day Staff Analysis

Restraint and Seclusion Debriefing Form – Next Working Day Team Analysis

Trauma Informed Care

Trauma Informed Care, prepared by the National Association of State Mental Health Program Directors (NASMHPD), for 2006 TASC Skills Building Conference (powerpoint)( references)

Traumatic Brain Injuries

Reducing the use of Restraint of Individuals Traumatic Brain Injury, by the Health Resources and Services Administration Federal TBI Program Webcast (July 27, 2006)

Transport

Vermont Passes Law Prohibiting Transport of Children in Shackles (June 2006) - The new law (H.306)--which covers the transport of pregnant woman in correctional settings, individuals residing in inpatient settings, and children within the jurisdiction of the state department of children and families -- generally establishes a policy disfavoring the use of restraint during transport and requires state officials to ensure that transport is done in a manner which prevents physical and psychological trauma, respects the privacy of the individual, and represents the least restrictive means necessary for the safety of the individual. The law also requires significant documentation and data collection about restraint use during transport.

Video Highlight

Find Help

If you are a person with a disability who is experiencing abuse and neglect, or know someone who is, call your P&A!
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