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Seclusion
and Restraint Data
State Hospitals and Psychiatric Programs
S/R Data / Data Charts / Definitions
Background
The California Department of Mental Health deems the safety of both individuals served and staff to be of paramount importance in our treatment settings. The use of seclusion and restraints has been used as a safety measure for dangerous and at-risk individuals when other less restrictive interventions have failed. However, while maintaining a safe treatment setting, the Department seeks to continually and substantially minimize the use of seclusion and behavioral restraint in the state hospitals and psychiatric programs, and to prevent the emergency situations that necessitate their use. In addition, individuals are viewed as partners and actively recruited to participate in efforts to discover effective ways for them to manage their symptoms and have their needs met without resorting to self harm or unsafe behavior.
State Hospitals and Psychiatric Programs
The California Department of Mental Health (DMH) currently operates five state hospitals with a combined average daily census of 878 individuals. Two facilities are located in southern California (Metropolitan State Hospital in Los Angeles County and Patton State Hospital in San Bernardino County), one facility near the central coast (Atascadero State Hospital) and one in northern California (Napa State Hospital). A fifth facility, Coalinga State Hospital in the central valley, opened its doors in September 2005. Please use the links below for additional information about each state hospital:
- Atascadero State Hospital (ASH)
- Coalinga State Hospital (CSH)
- Metropolitan State Hospital (MSH)
- Napa State Hospital (NSH)
- Patton State Hospital (PSH)
DMH also operates two psychiatric programs located at correctional facilities under contract with the California Department of Corrections and Rehabilitation (CDCR). Salinas Valley Psychiatric Program (SVPP) is located at Salinas Valley State Prison and the Vacaville Psychiatric Program (VPP) is located at the Correctional Medical Facility at Vacaville. Please use the links below for additional information about each psychiatric program:
Seclusion and Restraint (S/R) Data
S/R data is presented quarterly for each hospital and psychiatric program. Posted information may be updated periodically to reflect revisions based on data or procedural updates.
Due to the time involved in processing data, there may be a lag time of up to two quarters before data can be posted on this website. The different data elements may have different lag times, but not more than two quarters. The lag time for each element will be noted.
| Report Title |
|---|
| Number of Seclusion Episodes |
| Number of Restraint Episodes |
| Number of Walking Restraint Episodes |
| Time in Seclusion |
| Time in Restraint |
| Time in Walking Restraint |
| Avg. Time per Seclusion Episode |
| Avg. Time per Restraint Episode |
| Avg. Time per Walking Restraint Episode |
| Data Tables for Charts |
| Report Title |
|---|
| Emergency Medication Administrations (Per 1000 Patient Days) |
| Report Title |
|---|
| Seclusion & Restraint Related Staff Injuries |
Definitions
Below are the definitions of seclusion, restraint and related topics used by the state hospitals and psychiatric programs:
- Seclusion
The involuntary confinement of a person alone in a room or an area from which the person is physically prevented from leaving. It does not include a “time-out” wherein a patient agrees to remain in an unlocked room or area and maintains the choice to leave without fear of adverse consequences or of being placed in seclusion or restraints.
- Behavioral Restraint
The mechanical restraint or physical restraint, used as an intervention when a person presents an immediate danger to self or to others. It does not include restraints used for medical or surgical purposes, including, but not limited to, securing an intravenous needle or immobilizing a person for a surgical procedure, or postural restraints, or devices used to prevent injury or to improve a person' s mobility and independent functioning rather than to restrict movement. It also does not include any type of mechanical or physical restraint used by the hospital police or law enforcement for transport, security or custodial purposes .
- Mechanical Restraint
The use of a mechanical device, material, or equipment attached or adjacent to the person's body that he or she cannot easily remove and that restricts the freedom of movement of all or part of a person's body or restricts normal access to the person's body, and that is used as a behavioral restraint. It does not apply to protective equipment such as helmets, mittens or spit nets, adaptive or postural support used in response to assessed physical needs of the patient, or to any type of mechanical restraint that is used by the hospital police or law enforcement for transport, security or custodial purposes.
- Walking Restraint
A “partial” restraints that allows an individual limited mobility but still prevents harm to self or others; intended as a less restrictive form of restraint (also referred to as an “ambulatory” restraint) .
- Emergency Medication
A situation in which action to administer medication over the individual’s objection is immediately necessary for the preservation of life or the prevention of serious bodily harm to the individual or others, and it is impracticable to first gain consent. It is not necessary for harm to take place or become unavoidable prior to the treatment. The data DMH collects for this purpose is any unscheduled delivery of at least one psychiatric medication in an emergency situation.
- Containment Related Injury
Serious injuries (those requiring more than simple first aid) sustained by staff or individuals during the use, or placing, of behavioral restraints or seclusion.
- An Emergency Psychiatric Medication Administration (EPMA)
Is defined as any unscheduled delivery of at least one medication (from a list of 38 psychiatric medications) given in response to an immediate need to reduce the danger posed by a psychiatric patient to self or others.
- A Containment Related Injury
Defined as any injury sustained by staff that occurs during the use of seclusion or behavioral restraints.
- Legal Class
The commitment category that allows an individual to enter a state hospital. The following legal classes are referred to in the data tables:
- LPS - refers to the Lanterman-Petris-Short Act that is the civil commitment law that allows admission to a state hospital. The county of residence must approve admission.
- NGI - Not Guilty by Reason of Insanity.
- IST - Incompetent to Stand Trial
- MDO - Mentally Disordered Offender
- SVP/MDSO - Sexually Violent Predator/Mentally Disordered Sex Offender (for purposes of reporting seclusion & restraint data these two legal classes have been combined. ASH, CSH (men) and PSH (women) are the only facilities that treat this population.
- California Department of Corrections and Rehabilitation and the Division of Juvenile Justice (CDCR/DJJ)
Individuals that have been transferred to a state hospital from CDCR or the DJJ under an interagency agreement. These individuals are usually treated and sent back to the sending department when they no longer need hospitalization.
- All - This refers to all legal classifications in the hospital.