Patient Ethnicity and Staff Use of Restraints and Restrictive Practice in Inpatient Psychiatric Services: A Systematic Review.

In 30 seconds

This systematic review examined whether patient ethnicity was associated with staff use of restrictive practices in inpatient psychiatric services. Following a search of four databases, 15 studies were included; they assessed seclusion (14 studies), forced medication (4), and physical restraint (4). Findings were mixed. Ethnicity predicted restrictive practice use in studies with larger participant numbers, longer follow-up, and less methodological bias, but the review could not establish whether ethnicity was an independent predictor or interacted with other risk factors.

Key findings

• The review included 15 studies: 14 examined seclusion, 4 forced medication, and 4 physical restraint.
• Findings on ethnicity and restrictive practice were mixed across the included studies.
• Ethnicity predicted restrictive practice use in studies with larger participant numbers, longer follow-up, and less methodological bias.

Why it matters

Restrictive practices can have serious consequences, and the review highlights uncertainty about whether their use varies by patient ethnicity. Awareness of possible unconscious bias and attention to factors beyond the individual patient may support more equitable assessment and care. The mixed evidence also underscores the need to interpret apparent ethnic differences cautiously.

What to keep in mind

The included studies had mixed findings, and the review could not determine whether ethnicity independently predicted restrictive practice use or interacted with other risk factors.