Physical restraint of children and adolescents in mental health inpatient services: A systematic review and narrative synthesis

Physical restraint is regularly used in children’s mental healthcare, often as a reactive behaviour management strategy. Physical restraint has been associated with physical injury but psychological consequences are poorly understood. The aim of this narrative systematic review was to examine physical restraint of children in inpatient mental healthcare services. Healthcare databases were searched to identify English language publications discussing anyone ≤18 years who had experienced physical restraint as an inpatient mental health patient. No date restrictions were applied. Sixteen quantitative studies, are included within this review. Most studies are retrospective in nature. Publications were appraised using the Critical Appraisal Skills Programme (CASP) quality assessment tool. Common characteristics associated with children who experience physical restraint include age, gender, diagnosis and history. Most studies associate physical restraint with the management of aggression. Findings suggest that it may be a combination of patient (intrinsic) and environmental (extrinsic) factors which ultimately lead to children experiencing restraint. This review confirms that little is known about children’s first-hand experiences of physical restraint. Future research should address children’s perceptions and first-hand experiences of physical restraint.