Five years ago, Christine Boyd was in the depths of depression and tried to take her own life. When she was admitted to an Ontario hospital, she expected to find help. Instead, she found herself tied down against her will.
Boyd remembers feeling calm when she arrived in hospital and was asked to lie down on a gurney.
"I didn't realize what was going to happen, so I compliantly laid down on the bed. Suddenly, the hall was full of people. Security guards had been hiding in the nurses' station. They swooped down on me and forcibly restrained me," she told CTV News.
Within a few minutes she was given a medication injection, a "chemical restraint" to keep her calm.
To this day, she is still outraged about what happened to her.
"At a time like that, when you feel so much despair that you want to take your own life, to be basically tied up and left alone battling those feelings is really very difficult," she says.
"I did not need to be in restraints. I needed to be treated with compassion, and to have my pain acknowledged. I needed to be watched and cared about, not tied up and left alone with my terrible self-destructive thoughts."
Sadly, stories like Christine's are not uncommon. In the largest study of its kind in Canada released this week, researchers with the Canadian Institute for Health Information found that one in four Ontario patients with mental health issues admitted to a community or psychiatric hospital are physically or chemically restrained.
Almost 60 per cent of the patients are controlled with drugs, while about 20 per cent are held down or mechanically restrained, and another 20 per cent are temporarily put alone in a room, the report found.
Stanley K. Stylianos, the program manager of the Ontario government's Psychiatric Patient Advocate Office, says the study shines a spotlight on a practice many Canadians may not be aware is regularly used.
"When we see numbers as high as they are, it does raise an alarm for us," he says.
More than half the people who restrained were posing a threat or danger to themselves, the report found. About one-third of those restrained were seen as a threat to staff, family members or other patients.
But the report also noted differences in the way that psychiatric hospitals handles patients and regular community hospitals do. Patients admitted to a general hospital for mental illness were about one-and-a-half times more likely to be restrained than those in a psychiatric hospital.
Boyd says the widespread use of restraints is often unnecessary.
"I should not have been deceived and tricked into lying on a restraint bed, then restrained without a warning or explanation about what was about to happen," she says.
"I do not believe that was an appropriate use of restraints …I was co-operative, not out of control. I needed supervision, not restraints."
Boyd also wonders whether she was restrained less for her sake than for the convenience of hospital staff, so they wouldn't have to watch over her. She says she wants Canadians to be aware there's a problem.
"I think it is important for people to know what goes on in psychiatric hospitals… They aren't aware of what's going on behind the walls. People are still being treated in ways that are barbaric, and violent," she says.
At Canada's largest psychiatric hospital, the Centre for Mental Health and Addiction in Toronto, only five per cent of patients are physically restrained, the hospital says. Staff are trained to use calming techniques to stop violent outbursts before they happen and use physical and chemical restraints as a last resort, says Rani Srivastava, CAMH's chief of Nursing and Professional Practice.
"People who experience that are further traumatized, which leads to more aggression and violence, which leads to more trauma. So, it really is to say that we have to stop this and we have to break the cycle," she explains.
"Restraints should be only for emergencies. Our goal is always the least amount of restraint for the least amount of time."
Stylianos says hospitals should go a step further and eliminate restraints altogether.
"I think striving towards restraint-free treatment environments should be the goal," he says. "Because the practice of restraint is so deeply embedded in the mental-health system, it's hard for some to imagine a time when restraint won't be needed. To strive towards that goal, there needs to be a concerted effort on behalf of hospital administration, hospital staff and a collaboration between hospitals and the people who are served by hospitals."
Boyd now advises hospitals on how to reduce or stop physically restraining patients, a mission she says that begins by letting Canadians know this still happens far too often behind hospital walls.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
