Physical Restraint in General Hospital Psychiatric Units in the Metropolitan Area of Rome

Since the enactment of the Mental Health Law of 1904, which institutionalized manicomi (centers for the mentally ill people), the elimination of the mechanical restraint in managing psychiatric patients has constituted a target and a quality indicator of Italian psychiatry. Currently, to verify if-and, if so, in what measure-this target is still significant despite the large use of psychomedicines in the clinical practice, the coordination center for the Psychiatric, Diagnosis, and Cure Services (SPDC) for the Lazio Region sponsored research on the use of mechanical restraints and characteristics in emergency situations, as well as on the risk factors that underlie its use. Subsequent research results have outlined the increased diffusion of restraint used as an emergency therapeutic-welfare practice and an increased variability frequency and duration in several SPDC regions. Finally, studies have statistically proved the significant influence of environmental risk factors both at the psychiatric unit level and at the territorial context in determining the use of restraint.