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March 2004
 Crisis
Prevention/Intervention Training & Risk Management:
An Essential Tool for Direct Care
Organizations
"To
detain maniacs in constant seclusion, and to load them with
chains is more distinguished for its convenience than
for its humanity or its success." These are the words of
Charles Goshen in Documentary History of Psychiatry (1967).
Chains were removed
from the insane in the 1700s in France.
Yet in 1998, The Hartford Courant (Connecticut) ran
a Pulitzer Prize winning series of articles, "Deadly Restraint,"
implicating restraints in the deaths of 142 people, more
than 26% children and adolescents, over a ten year period.
Congress established standards in the Children's
Health Act (2000) that restricts the use of restraints
and seclusion for children and
adolescents in psychiatric facilities that
receive federal funds, and the Center
for Medicaid and Medicare Services
responded by issuing new rules
regarding their use in psychiatric residential
treatment facilities that provide Medicaid
services for individuals under
21.
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