Why restraint is completely unnecessary | Behavioral Healthcare Executive Skip to content Skip to navigation

Why restraint is completely unnecessary

November 3, 2014
by Lori Ashcraft
| Reprints
Lori Ashcraft

I recently had the honor of speaking with Elyn Saks. She was diagnosed with schizophrenia as a teenager, and now as a law scholar and writer, she speaks for the rights of people with mental illnesses. Saks has written several books, done a TED Talk, and many other things related to her commitment of improving the lives of people with mental illness. Speaking to her gave me a personal feeling for her brilliance, resilience and her commitment to her work.

In this interview, Saks provided me with intimate details of her journey through a series of treatments that were supposed to help her heal. Some of them did and some of them definitely didn’t. As you listen to her story you’ll hear her strength and resourcefulness shining through. She is definitely a rare and wonderful human being. Today, her condition is controlled by medication and therapy.

Risk sharing

I first met Saks a few years back when she invited me to join a symposium she was hosting related to the negative effects of restraint and seclusion. It’s clear why this is such an important topic for her.

 I am convinced that restraint is completely unnecessary and that a more therapeutic approach is to create relationships with people that promote risk sharing in place or risk management. I know this is a controversial topic, but I stand by my beliefs on this. Too many people have told me that being restrained is the worst thing that ever happened to them. Saks certainly is among those.

“Risk sharing” is what has worked for Saks since her last hospitalization in 1983. Since then, there have been times when she says, “I probably should have been hospitalized, but I just couldn’t go there.” Her treatment team has been willing to share the risk with her and treat her on an outpatient basis. Saks knows this has increased the anxiety level of her team, but their willingness to share the risk with her has allowed her healing to take place without retraumatizing her.

If you want to review all of Saks’ amazing accomplishments, just Google her name. You’ll find an impressive list of education degrees, a long list of articles and book chapters she has written, and the titles of the four books she has authored including “The Center Cannot Hold” that was published in 2007.

The memoir chronicles her recovery from schizophrenia which was diagnosed early in her teens. Her first diagnosis was incorrect and she was treated and medicated for an illness she did not have, while the one she did have remained untreated.

Like many of us who are in recovery, Saks still experiences times when the illness ambushes her, causing her to step back just a little before she regroups and re-enters the match. “The Center Cannot Hold” is a first-person account of a long and frightening journey that still continues. We keep reading this book because we know it’s going to have a happy ending.

In conclusion, of all the meaningful contributions Saks has made to the field of recovery, the one that stands out for me is the unparalleled evidence that being diagnosed with a mental illness is not the end of an exceptional life. She shows us how to keep trying, how to work around meaningless systemic barriers to get the right treatment, and how to encourage, stretch and grow the professionals that work with us.


More Online

See the video interview below.

The password is Elyn Saks.