HARTFORD, Conn. (October 11, 1998 - AP) -- Hundreds of people across the nation have died after being restrained in psychiatric and mental retardation facilities in the past decade, the Hartford Courant reported Sunday.
The newspaper's investigation confirmed 142 restraint-related deaths, many involving children, since 1988. The true death count may be three to 10 times higher because many cases are not reported to authorities, according to a statistical estimate commissioned by the Courant.
Restraints such as straitjackets and bed straps, supposed to be used only as a last resort, are commonly used for discipline, punishment or the convenience of staff at psychiatric and mental institutions, the newspaper said.
"It's going on all around the country," said Dr. Jack Zusman, a psychiatrist and author of a book on restraint policy.
Health care officials say restraints are used less frequently and more compassionately than ever before.
"When it comes to restraints, the public has a picture of medieval things, chains and dungeons," said Dr. Kenneth Marcus, psychiatrist in chief at Connecticut Valley Hospital in Middletown, Conn. "But it really isn't. Restraints are used to physically stabilize patients, to prevent them from being assaultive or hurting themselves."
The federal government does not collect data on how many patients are killed by restraints. Neither do state regulators, academics or accreditation agencies.
The Harvard Center for Risk Analysis put the estimate between 50 and 150 deaths a year, based largely on data from the U.S. Department of Health and Human Services and New York, the only state that investigates all deaths in institutions.
The newspaper's investigation was prompted by the death of 11-year-old Andrew McClain, who died while being restrained in a Portland, Conn., psychiatric hospital in March.
The newspaper found:
-- 23 people died after being restrained in face-down floor holds such as the one in which McClain died.
-- 20 died after they were tied up in leather wrist and ankle cuffs or vests, and ignored for hours.
-- Causes of death could be confirmed in 125 cases. Of those patients, 33 percent died of lack of oxygen, another 26 percent died of heart-related causes.
-- Ages could be confirmed in 114 cases. More than 26 percent of those were children, nearly twice the proportion they constitute in mental health institutions.
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[posted October 16, 1998]
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