Background

Physical and mechanical restraints used in treatment, care, education, and corrections programs for children are high-risk interventions primarily due to their adverse physical, emotional, and fatal consequences.

Objective

This study explores the conditions and circumstances of restraint-related fatalities in the United States by asking (1) Who are the children that died due to physical restraint? and (2) How did they die?

Method

The study employs internet search systems to discover and compile information about restraint-related fatalities of children and youth up to 18 years of age from reputable journalism sources, advocacy groups, activists, and governmental and non-governmental agencies. The child cohort from a published study of restraint fatalities in the United States from 1993 to 2003 is combined with restraint fatalities from 2004 to 2018. This study’s scope has expanded to include restraint deaths in community schools, as well as undiscovered restraint deaths from 1993 to 2003 not in the 2006 study.

Results

Seventy-nine restraint-related fatalities occurred over the 26-year period from across a spectrum of children’s out-of-home child welfare, corrections, mental health and disability services. The research provides a data snapshot and examples of how fatalities unfold and their consequences for staff and agencies. Practice recommendations are offered to increase safety and transparency.

Conclusions

The study postulates that restraint fatalities result from a confluence of medical, psychological, and organizational causes; such as cultures prioritizing control, ignoring risk, using dangerous techniques, as well as agencies that lack structures, processes, procedures, and resources to promote learning and to ensure physical and psychological safety.

中文翻译：

---

一项为期 26 年的美国儿童和青少年约束性死亡研究：组织结构和流程的失败

背景

用于儿童治疗、护理、教育和矫正计划的身体和机械约束是高风险干预措施，主要是由于其不利的身体、情感和致命后果。

目标

本研究通过询问 (1) 谁是因身体约束而死亡的儿童？(2) 他们是怎么死的？

方法

该研究使用互联网搜索系统从知名新闻来源、倡导团体、活动家以及政府和非政府机构中发现和汇编有关 18 岁以下儿童和青少年与约束相关的死亡信息。1993 年至 2003 年美国已发表的约束性死亡研究中的儿童队列与 2004 年至 2018 年的约束性死亡人数相结合。这项研究的范围已扩大到包括社区学校的约束性死亡，以及 1993 年至 1993 年未发现的约束性死亡。 2003 年不在 2006 年的研究中。

结果

在 26 年的时间里，79 起与约束相关的死亡事件发生在儿童离家儿童福利、矫正、心理健康和残疾服务的范围内。该研究提供了数据快照和示例，说明死亡人数如何发生及其对工作人员和机构的影响。提供实践建议以提高安全性和透明度。

结论

该研究假设约束性死亡是由医疗、心理和组织原因共同造成的；例如优先控制、忽视风险、使用危险技术的文化，以及缺乏促进学习和确保身心安全的结构、流程、程序和资源的机构。