The Oregon Human Services Department’s Addictions and Mental Health Division has finally released, after some cajoling, promised data on the number of times adult persons with mental illness are locked in seclusion or physically restrained in public and private hospitals.
The data is segmented by each hospital, and for the four quarters of 2008. Unsegmented data was available earlier in the year, as was segmented data for children’s residential treatment centers. The children’s data was posted on this site on December 11, 2008.
The full data is available on a PDF here – Hospital Seclusion and Restraint Occurrences per 1000 Patient Days: 2008
Seclusion and restraint are consider last measures in most if not all inpatient facilities, so this data acts as a “canary in the coalmine” to express the stress of under-management or under-staffing a facility is experiencing.
Seclusion is when a patient of the medical facility is locked in a room alone. We assume “patient days” equal 24 hours.
Oregon State Hospital in Salem shows the highest number of patient seclusion occurrences, but that number must be divided by the far larger number of patient days than any other facility in the state.
OSH 1st quarter – 322 seclusions over 61712 patient days for 5.2 seclusions per 1000 patient days, 2nd quarter – 183 over 61892 for 3.0, 3rd quarter – 255 over 63001 for 4.0, and 4th quarter – 283 over 62265 for 4.5.
The Portland Veterans Administration Medical Center (AKA “The Flight Deck”) shows the highest figures for seclusion occurrences divided by patient days. The VA’s numbers are FAR higher than other similar facilities, and the VA has failed to submit data for the 2nd, 3rd, and 4th quarters on restraint and seclusion to the state, as we understand it, which is proscribed by law.
VA 1st quarter – 67 seclusions over 1620 patient days for 41.4 seclusions per 1000 patient days.
The psychiatric wards at Oregon Health and Sciences University often see people who are not only very ill, but are also physically ill, injured or frail. Their statistics show a middle line use of seclusion based on the provided data.
OHSU 1st quarter – 5 seclusions over 1820 patient days for 2.7 seclusions per 1000 patient days, 2nd quarter – 15 over 1820 for 8.2, 3rd quarter – 5 over 1840 for 2.7, 4th quarter – 4 over 1840 for 2.2.
All data in this report comes from the hospitals themselves. Data provided by several hospital show minimal or no use of seclusion. These hospitals include Legacy Good Samaritan in Portland, Sage View in Bend, and Salem Memorial Hospital. If you can testify to an experience which is different than the hospital data as presented, please contact us at firstname.lastname@example.org.
Restraint is when a patient of a medical facility to bound to a wall, floor, bed, chair or wheelchair. Again, we assume “patient days” equal 24 hours.
Again because of the size of it’s patient population, the Oregon State Hospital has the highest raw numbers of patient restraint occurrences, but to make comparable sense of the numbers, the state expresses the data as number of occurrences divided by patient days. With this formula, the state hospital has very reasonable numbers in comparison to other Oregon facilities.
OSH 1st quarter – 174 restraints over 61712 patient days for 2.8 restraints per 1000 patient days, 2nd quarter – 87 over 61892 for 1.4, 3rd quarter – 155 over 63001 for 2.5, and 4th quarter – 172 over 62265 for 2.8.
The Veteran’s Administration in Portland has the highest number of restraint occurrences in comparison to other facilities in Oregon. It’s very worrying that the VA has been either unwillling or unable to provide data for it’s restraint occurrences for the 2nd, 3rd, or 4th quarter – as every other Oregon hospital has done.
VA 1st quarter – 25 restraints over 1620 patient days for 15.4 restraints per 1000 patient days.
Again, OHSU gives an example of a middle line of use of restraints on it’s psychiatric patients.
OHSU 1st quarter – 2 restraints over 1820 patient days for 1.1 restraints per 1000 patient days, 2nd quarter – 3 over 1820 for 1.6, 3rd quarter – 1 over 1840 for 0.5, 4th quarter – 1 over 1840 for 0.5.
This data shows Oregonians that seclusion and restraint are current and constant practices in many psychiatric hospitals, and that some hospitals, such as the Veteran’s Administration Medical Center in Portland, use these practices on a more aggressive basis.