Practitioner Explanations for the Increasing Use of Restraint Measures in the Care of People With Intellectual Disabilities in Norway 2000–11

Abstract

AbstractThe use of restraint measures in the care of people with an intellectual disability (ID) and challenging behavior (CB) is recognized as problematic around the world and attempts have been made to reduce reliance upon this coercive approach. In Norway, legislation was enacted to restrict the use of restraint but paradoxically since it was implemented in 1999 there has been a very large increase in the use of one form of restraint: statutory or planned interventions. This study examined professionals' explanations for this unexpected increase. ID care staff (n = 178) and local government supervisors (n = 17) completed a semi‐structured questionnaire (total n = 195). All participants were involved directly or indirectly in implementing restraint. Comparisons were made between the different levels of care staff and the supervisors. The care staff interpreted the increase as due to greater awareness of the regulations and restraint interventions. Supervisors had low expectations of a decrease in restraint rates in the future. It was felt that the new regulations on the use of restraints in the care of people with ID and CB had raised awareness of ethical issues and improved education on this topic. Future research should address possible strategies for sustaining these improvements and at the same time stabilizing or reducing the number of people receiving restrictive care.