Psychiatric Restraint Use as Carceral State Practice

Evidence in the United States is mounting that the roles of police and clinicians are often blurred. Police have become de facto first responders in behavioral health crises, leading to hundreds of people injured or killed in recent years, and clinicians can direct involuntary hospital admissions and forced physical restraints to coerce and control patients. This blurring of roles has disproportionately affected people with complex medical conditions, including severe mental illness; people who are Black; and people at the intersection. In this issue, Singal and colleagues (1) build on this literature by examining racial-ethnic inequities in the frequency and duration of restraints among 29,739 patients in an inpatient psychiatric facility from 2012 to 2019. The authors found that Black and multiracial patients experienced more and longer restraint events than White patients experienced.