By the same authors

From the same journal

Manual restraint and shows of force: the City-128 study

Research output: Contribution to journalArticle



Publication details

JournalInternational Journal of Mental Health Nursing
DateE-pub ahead of print - 6 Jul 2011
DatePublished (current) - Feb 2012
Issue number1
Number of pages11
Pages (from-to)30-40
Early online date6/07/11
Original languageEnglish


Manual restraint is used to manage disturbed behaviour by patients. This study aimed to assess the relationship of manual restraint and show of force to conflict behaviours, the use of containment methods, service environment, physical environment, patient routines, staff characteristics, and staff group variables. Data from a multivariate, cross-sectional study of 136 acute psychiatric wards in England were used to conduct this analysis. Manual restraint was used less frequently on English acute psychiatric wards (0.20 incidents per day) than show of force (0.28 incidents per day). Both were strongly associated with the proportion of patients subject to legal detention, aggressive behaviours, and the enforcement of treatment and detention. Medical, nursing, and security guard staff provision were associated in different ways with variations in the use of these coercive interventions. An effective ward structure of rules and routines was associated with less dependence on these control methods. Training for manual restraint should incorporate the scenarios of attempted absconding and enforcement of treatment, as well as violent behaviour. Attempts to lessen usage of these interventions could usefully focus on increasing the availability of medical staff to patients, reducing reliance on security guards and establishing a good ward structure.

Bibliographical note

© 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

    Research areas

  • Aggression, Coercion, Cross-Sectional Studies, England, Female, Humans, Male, Mental Disorders, Psychiatric Department, Hospital, Restraint, Physical, Security Measures

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