RT Journal Article
SR Electronic
T1 Patient Choice: Deciding Between Psychotropic Medication and Physical Restraints in an Emergency
JF Journal of the American Academy of Psychiatry and the Law Online
JO J Am Acad Psychiatry Law
FD American Academy of Psychiatry and the Law
SP 321
OP 329
VO 21
IS 3
A1 Sheline, Yvette
A1 Nelson, Teresa
YR 1993
UL http://jaapl.org/content/21/3/321.abstract
AB The legal requirement to use least restrictive interventions in emergency psychiatric treatment does not stipulate whether physical restraints or medication is least restrictive. There is no current consensus about how to determine least restrictive interventions in a generalizable manner. In this study patients who were clients in a public psychiatric emergency service were anonymously surveyed and asked to state their preferences for specific interventions in a psychiatric emergency. In a choice between physical restraints versus psychotropic medication, 64 percent of clients preferred medication; 36 percent preferred seclusion or restraint. The rank order of preferred modality was 1) benzodiazepines—31 percent, 2) neuroleptics—26 percent, 3) seclusion—24 percent, 4) restraints—10 percent. The rank order of last choice was different. Patients preference is an important factor in determining the appropriate intervention in an emergency. Patient participation offers an opportunity reconcile to clinical and legal objectives, to i mprove compliance, and to enhance patient and staff safety.