Use of seclusion and restraint in psychiatric patients in Harare Hospital Psychiatric Unit, Zimbabwe: gender differences

Abstract

Objective: To examine the frequency and indications for use of seclusion and restraint of psychiatric patients in relation to gender differences and risk factors in Harare Hospital Psychiatric Unit.

Design: Descriptive study.

Setting: Harare Central Hospital Psychiatric Unit, Harare, Zimbabwe.

Subjects: 95 consecutively secluded/restrained patients were recruited for the study.

Main outcome measures: The frequency of seclusion and the characteristics of patients secluded/restrained.

Results: 54 (56.8%) patients were males and 41 were females. They had a median (Q1, Q3) age of 30 (Q1, = 24, Q3 = 36) years. Over two thirds (70.5%) of them were aged 35 years or less. The frequency of seclusion and restraint was 8.5% (95% CI 6.9 to 10.1) of the population of 1,115 patients admitted during the study period. The groups (male versus female) differed significantly with respect to marital status; single patients being 4.66 (95% CI 1.17 to 19.96) times more likely to be males when compared to the divorced/separated patients. Male patients were more likely to have been brought by police than by their relatives or friends (OR 3.30; CI 1.19 to 9.73; p = 0.020).

Conclusion: Seclusion/restraints of psychiatric patients were common in a psychiatric unit. Male patients were more likely to be brought by police. Female patients resorted more to physically assaulting staff/other patients than did male patients.