Background: Physical restraint, although intended to prevent imminent harm, remains ethically controversial in psychiatric care. The Mental Healthcare Act (MHCA) 2017 introduced guidelines to minimize coercive practices in India, yet data on its implementation remain scarce. Objectives: To assess the sociodemographic and clinical correlates of physical restraint in psychiatric inpatients following the implementation of MHCA 2017. Settings and Design: A retrospective case record study was conducted at a tertiary psychiatric institute in Goa. Methodology: All patients who underwent physical restraint between April 1, 2022 and March 31, 2023 were included. Data were extracted from Physical Restraint Monitoring and Reporting Forms and case records. Sociodemographic and clinical variables were analyzed using the descriptive statistics. Results: Of 917 admissions during the study period, 255 patients (27.80%) were physically restrained. The majority were male (63.92%), aged 30–45 years, unmarried, unemployed, and from lower socioeconomic backgrounds. Psychotic disorders (31.37%), bipolar disorder (30.59%), and substance use disorders (30.19%) were most frequently associated. Restraint was primarily for aggression or risk to others (96.47%), with a mean duration of 20.53 ± 7.59 min. Nearly 93% received concurrent chemical restraint. Those with psychotic disorders were more likely to require repeated restraint. Conclusions: Young, single, unemployed males with psychotic disorders, and aggressive behavior are at higher risk of requiring physical restraint. While restraint remains prevalent post-MHCA 2017, recognizing these risk profiles can facilitate the development of personalized preventive strategies aimed at minimizing the need for the same.
Braganza et al. (Wed,) studied this question.
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