Introduction
Background
There are many misconceptions regarding Seclusion and Restraint (S&R) practices in mental health intensive treatment facilities. In the past, these interventions were perceived as a therapeutic way to create a safer, more secure environment for consumers and staff. However, more current research has shown that S&R:
- Can pose psychological and physical risks to both consumers and staff (U.S. Department of Health and Human Services, 2010).
- Can have serious consequences including physical repercussions, mental repercussions, and has even resulted in death. There is no evidence that S&R is effective in reducing problem behaviors in children (U.S. Department of Education, 2012).
The U.S Department of Health and Human Services has aimed to promote alternatives to S&R (U.S. Department of Health and Human Services, 2010). At both the federal and state levels, the number of S&R instances has been monitored in child-caring agencies such as psychiatric residential and day treatment providers. Measuring utilization of S&R is important for tracking trends in use, monitoring progress towards elimination, and quality improvement.
Use of Seclusion and Restraint
Federal and state regulation for youth treatment states that S&R interventions should only be used when:
- A child's behavior poses a reasonable risk of imminent serious bodily injury to the child or others, and
- A less restrictive intervention would not effectively reduce the risk, and
- After attempts at de-escalation have failed.
Senate Bill (SB) 710 (2021) outlined additional provisions for what is prohibited and permissible relating to restraint and seclusion of children receiving services from licensed child-caring agencies in Oregon. SB 710 added new reporting requirements any time restraints or seclusion are used on a child in care. In addition, the bill created a new requirement that Oregon-based secure transportation service providers have to become licensed as child care agencies if they are transporting any child in care who resides in Oregon or is being transported through Oregon to or from a school, an organization, or other child caring agencies.
The Dashboard
Please allow a few moments for the dashboard to load.
Use the dropdown filters to select facilities and to view year-to-year comparison.
See the S&R Data Interpretation Guide to view supplemental material about the data.
About the Data
Where do these data come from?
The Quarterly Seclusion and Restraint reports are posted under each child caring agency, and can be accessed from the Child-Caring Agency Licensing Reports page. This dashboard uses data submitted by licensed providers to Oregon Health Authority (OHA), which processes, verifies, and enters the data into the system for reporting and analysis.
Known data issues
Due to data coding errors in the 2020-2022 data, some information was excluded from this report. The data for 2020-2022 has not been altered since it has already been published, and the 2023 data has been validated multiple times to ensure those errors are not repeated.
What are rates and how are they calculated?
A
rate is a measure of the frequency with which an event occurs in a defined population over a specified period of time. For example, a seclusion rate of 3.4 per 1,000 patient days means that for every 1,000 patient days, 3.4 seclusions occur.
Rates make it possible to compare S&R data across different facilities, because it is adjusted for the total number of patient days that occurred in the facility.
Seclusion Rate = number of seclusions / total patient days * 1,000
Restraint Rate = number of restraints / total patient days * 1,000
*where patient days = average daily census * number of days in reporting period
Previous Seclusion and Restraint reports
Glossary
Child-caring agency: Any private school, private agency, private organization or county program providing care or services for children such as adoption placement services, residential care, outdoor youth programs, day treatment for children with emotional disturbances, and other similar programs.
Seclusion: The involuntary confinement of a child in care alone in a room from which the child in care is prevented from leaving by any means.
Restraint: The physical restriction of a child in care's actions or movements by holding the child in care or using pressure or other means.
S&R: Seclusion and Restraint
ITS: Intensive Treatment Services
PDTS: Psychiatric Day Treatment Services
PRTS: Psychiatric Residential Treatment Services
SCIP: Secure Children's Inpatient Treatment Programs
SAIP: Secure Adolescent Inpatient Treatment Programs
Sub-acute psychiatric care: Services that are provided by nationally accredited providers to children who need 24-hour intensive mental health services.
Patient/Resident days: means the day of admission plus each additional day of stay and are calculated by multiplying the total population or census of patients/residents in the facility each day by the number of days in the reporting period. The population/Census is determined by averaging the daily census during the reporting period.
General Information
Accessibility
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Suggested Citation
Children and Adolescent Seclusion and Restraint Rates (2025). Interactive display accessed [MM/DD/YYYY]. Salem, OR: Oregon Health Authority. https://www.oregon.gov/OHA/HSD/BH-Child-Family/Pages/Seclusion-Restraint-Rates.aspx
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