7(B)(iii). Staff views

The reasons that straps are used appear to be similar to the justifications given to cage beds, with two subtleties. First, straps are used more on men as some are seen to be too strong for cage beds. Second, straps are apparently more treatment-focused because strapping a person allows medical staff to render the patient’s body (or at least an arm) nearly motionless so that an injection can be given.

A doctor at Plzeň Hospital Psychiatric Department told the monitoring team that during the night there were two nurses for 25 patients, so restraints were “necessary for newly-admitted patients who are in acute conditions or patients who are trying to escape or attack [other] patients and nurses”. Straps are necessary due to, “the safety and benefit of the patients”, he explained. A 36-year-old patient at Kosmonosy Psychiatric Hospital said that “everyone is who is admitted is put in straps for prevention, whether they come by ambulance or police”. A 30-year-old patient explained how, “they usually strap newly-admitted patients, just for one-two days. There is a special room with beds which have straps.”

A doctor at Kosmonosy Psychiatric Hospital said that she could not imagine treating a patient in a seclusion room. “On the other hand”, she added, “everything is possible in straps.”

At Klatovy Hospital Psychiatric Department, MDAC monitors were told that people with alcoholism were strapped if staff had to give infusions for which they needed access to the patient’s arm. Straps were used for patients having hallucinations and those who harmed themselves, other people, or had destroyed cage beds.

At Opava Psychiatric Hospital, a nurse confirmed that patients could be strapped “just for an hour” to receive injections. This means that the straps were used not only at the time of the injection, but for an extended period of time thereafter.

Similar to the use of cage beds, straps were used to prevent patients from falling, according to some staff. At Dobřany Psychiatric Hospital, where cage beds have been removed, staff instead used small round straps which were placed on a patient’s wrist and affixed to the side of the hospital bed with a Velcro fastener. In the detox unit of Prague Bohnice Psychiatric Hospital, straps were used for situations of “restlessness” according to the director, or when staff consider patients to be “dangerous” to themselves or others. There is no assessment tool to evaluate perceived dangerousness.