Appelbaum Kenneth L
Center for Health Policy and Research, Commonwealth Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
J Am Acad Psychiatry Law. 2007;35(4):431-5.
In contrast to the position taken in the American Psychiatric Association's "Resource Document on The Use of Restraint and Seclusion in Correctional Mental Health Care," this commentary proposes limiting the use of mental health restraints to the stabilization of unsafe situations during the time it takes to transfer an inmate to a psychiatric hospital. Jails and prisons are inherently nontherapeutic environments and are not adequate settings for managing mental health emergencies, such as those that require the use of restraints. Correctional conditions often contribute to the onset, and impede the resolution, of the underlying mental health crisis. Attempts to contain mental health emergencies in a correctional setting with an expanded use of restraints can compromise clinical care, overlook the root cause of many crises, impair the role of mental health professionals by blurring the distinction between mental health and security staff, and can lead to a deterioration in the standards of care.
与美国精神病学协会《惩教心理健康护理中约束和隔离使用的资源文件》中的立场相反，本评论提议将心理健康约束的使用限制在将囚犯转移到精神病医院所需时间内稳定不安全状况的范围内。监狱本质上是非治疗性环境，不是管理心理健康紧急情况（如那些需要使用约束措施的情况）的合适场所。惩教条件往往会导致潜在心理健康危机的发生，并阻碍其解决。试图通过扩大约束措施的使用来控制惩教环境中的心理健康紧急情况，可能会损害临床护理，忽视许多危机的根本原因，因模糊心理健康和安保人员之间的区别而损害心理健康专业人员的作用，并可能导致护理标准的下降。
