Excess use of non-emergency restraint among older psychiatric patients

Higher rates of acute control medications and restraints were used in older adults in Ontario psychiatric hospitals between 2005 and 2018. Restrictive interventions like acute control medications and restraints are more likely to be used in non-emergency situations among older psychiatric inpatients than younger ones, a study shows. Researchers found a clear pattern of higher rates of these controls being used in older adults in Ontario psychiatric hospitals between 2005 and 2018. " When considering non-emergency use of control interventions, this approach to care was most common in older adults, with the highest rates of restraint among the oldest-old," said John Hirdes , a professor at the University of Waterloo's School of Public Health Sciences and the study's senior investigator. The researchers examined 226,119 Ontario inpatient records during these years to determine how often older psychiatric inpatients are restrained in non-emergency situations compared to younger age groups, and to identify the factors associated with this non-emergency use in older psychiatric inpatients. They used data from the interRAI Mental Health assessment instrument-a comprehensive standardized assessment used routinely in psychiatric settings. The rate for the oldest age group, 85 and over, was 1.6 times higher than among 45- to 64-year-olds (13.3 per cent compared to 8.3 per cent).