To the Editor: As chairperson of the American Psychiatric Association's committee in patient safety, I applaud the inclusion of the articles on seclusion and restraint in the September issue of Psychiatric Services (1,2,3,4,5). The safe and minimal use of seclusion and restraint is one of the committee's first three initiatives. Reading these articles makes one realize that this particular patient safety goal is well on its way to being achieved.
However, I would also argue that, for most acute psychiatric settings, total elimination of seclusion and restraint is not a practical goal unless one puts dogma ahead of both patient safety and staff safety. Rather, I would argue that the goal should be safe, judicious, and minimal use of seclusion and restraint.