Global Journal of Human-Social Science, A: Arts and Humanities, Volume 23 Issue 5

The Impact of Mechanical vs Physical Restraints: A Call for Awareness Boris Bard Abstract- There are various illnesses and drug-induced medical conditions that can trigger violent behavior in individuals, directed towards others or even themselves. In such cases, the use of mechanical or physical restraints becomes necessary to manage the violence. This article sheds light on the ethical, psychological, and physical aspects associated with the utilization of restraints. It also discusses current practices, regulations, and proposes alternative approaches that prioritize the well-being, safety and dignity of individuals affected by these restraints and medical staff. Keywords: mechanical physical restraints, violence, zero restraints policy, restraints design, safety, mental health, violence, aggression, handcuffs, amygdala. I. C ar I ndustry N eeds in R estraints ear reader, have you ever noticed what is the first thing you do when you sit in the car when you are driving? It is very strange that you automatically, and unconsciously put the seat belt on. Without any external threat, you voluntarily give up your freedom and restraint yourself with the car seat belt. Why is that? There is a chain of events that lead you to do so. In 1855, an English engineer Claghorn got the first patent for a seat belt. “In 1959, NIlls Bohlin, an engineer at Volvo, created the familiar three-point seat belt that greets you in the car now” [1]. to another research safety is the second main parameter that impacts sales [6]. As per John Kander’s quote, "Money makes the world go around.” [7]. Thus, we have the most comfortable and safe car seat belt designs possible. II. M ental H ealth I ndustry N eeds in R estraints to address symptoms, search for dangerous objects among their belongings, and attend to their acute D Volume XXIII Issue V Version I 19 Global Journal of Human Social Science - Year 2023 ( ) A © 2023 Global Journals Author: e-mail: bard.boris@gmail.com As for safety in the car, in medicine it is also important to ensure safety for the patients as well as the staff. Hence, often we need to limit or mechanically restraint patient’s body movements. Despite a constant improvement in what can be done to reduce the number, the duration and comfort of mechanical restraints, it is not possible to eliminate them totally. We can continue to try to improve the culture, physical comfort and education we provide for staff by teaching them advanced de-escalating techniques to ensure minimized use of mechanical restraints. Unfortunately, there are some extremely violent patients who are not responding to any de-escalation techniques. Restraints should be used as a last resort, when we have exhausted all other ways to ensure safety and in emergency. For example, in certain cases and instances when the patient is extremely agitated, violent and aggressive, the use of mechanical restraint is warranted. From writer’s experience, the typical cases requiring mechanical restraints are in emergency room department. For example, patients coming with drug induced psychosis, mania or patients suffering from schizophrenia and schizoaffective disorder who are either untreated or non-compliant with their treatment. III. Z ero R estraints P olicy as a F reedom to F ight In response to public criticism regarding the excessive use of mechanical restraints, many organizations have swung to the other extreme by adopting a "zero restraint policy." Under this new approach, they have completely eliminated the use of any mechanical restraints in their practices. Based on the writer's experience, the implementation of a "zero restraints policy" ultimately results in staff having to engage in physical altercations with patients to ensure their care and safety. Staff members are required to move patients from one location to another, administer acute care medications What is surprising is that civil liberties advocates fought against seat belts. The first ever seat belt law, globally was in Victoria, Australia in 1970. However, in North America the first seat belt mandate was in Ontario, Canada in 1976 [2]. In USA, though the fight for mandatory seat belt started in 1973 and ended only in 1977, when Regan administration decided to give, "freedom”, lost the case in supreme court and USA had to regulate the industry and mandate the seat belts [3]. In Michigan, David Hollister, the representative hired to lead the mandatory seat belt legislation, received a letter comparing him with Hitler. As per Hollister, "We finally won the civil liberties argument by saying they're arguing for the right to go through the windshield" [2]. Today most of us have no problem putting the seat belt on while driving to be safe. The use of seatbelts is directly linked to the comfortable and easy to use design. The more complex design which takes more effort to put on, the less chances there are that people will use them [4]. It was found that aging and increase in Body Mass Index, for example, impact the seat belt’s comfort [5]. According