The METO Settlement

Roberta Opheim: A restraint is supposed to be for the minimum amount of time necessary for the person to regain behavioral control. Some of these would be for 50 minutes, because for some people, the minute you restrain them, they immediately started to fight against the restraint, scream, holler.

They actually got more worked up because of the restraint to the point where they weren't even able to calm themselves down. So what we found was that the policy said no restraint should go on for more than 50 minutes. We found that some were in there for 50 minutes and then continued beyond that. In other cases, they would write it up as a new restraint. So we had people in back to back restraints for maybe up to three 50-minute periods.

All of that time, the adrenaline is going, which we know puts the risk on the cardiovascular system so that all of the systems are impaired. In fact, in other restraints, whether they be law enforcement settings or whatever, we've seen people die from either a restriction of the airway or what they call excited delirium, where the system is so worked up that the body can no longer handle that much adrenaline in it. And so they may not die during the restraint, but they might die after the restraint.

Fortunately, during the course of this review, we did not see a specific death there related to restraints. But our office reviews deaths and serious injuries. They had had serious injuries occur during a restraint, which again speaks to the training of the staff. We're well aware of deaths all over the country that happen during restraints in treatment programs. So it's a high-risk procedure, and we felt that it was only a matter of time before someone else got hurt again or a more catastrophic event happened.