The Joint Commission revises restraint and/or seclusion requirements for BHC organizations

The Joint Commission has released new and revised requirements applicable to behavioral healthcare and human services (BHC) organizations that use restraint and/or seclusion. In their announcement, The Joint Commission stated that "[p]hysical holding restraints can be as dangerous as other types of restraint and should be held to the same requirements, as evidenced by a study that examined data collected over 26 years regarding restraint fatalities among children and adolescents in the United States." Because this standard is effective immediately, facilities should confirm compliance with the requirement and be prepared to address and remedy any noncompliance existing at the time of their next survey.

The Joint Commission is updating the definition of "restraint" in the glossary of the Comprehensive Accreditation Manual for Behavioral Health Care and Human Services:

Restraint is any method (chemical or physical) of restricting the freedom of movement of an individual served to manage their behavior. This includes any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of an individual to move their arms, legs, body or head freely. It also includes any drug or medication when it is used as a restriction to manage the individual's behavior or to restrict their freedom of movement and is not a standard treatment or dosage for their condition.

Examples of what is not considered a restraint is also included:

• briefly holding an individual to calm or comfort them
• physically assisting someone to complete a task
• escorting or guiding someone away from an area or situation
• separating individuals to break up a fight
• physical interventions to prevent imminent danger (stopping an individual from running into traffic, tripping, or falling)

The changes to the Comprehensive Accreditation Manual for Behavioral Health Care and Human Services affect any BHC organization accredited by The Joint Commission and provide best practices for other entities.

Norton Rose Fulbright lawyers will continue to follow updates from The Joint Commission.