Reducing Restraint: Thoughts on Balancing Safety

Taking a quick side step from my usual discussion about violence prevention in health care and mental health, I wanted to drop a note here about legislative activity in the world of education.

In 2010, Secretary of Education Arne Duncan called upon all states to provide the US Department of Education with a copy of their state policy or guideline on the use of de-escalation, restraint, and seclusion in their schools. Since that time, several states that did not have a rule, policy, or guideline have developed one, while others have worked to update their existing regulations to reflect current best practices.

Keeping All Students Safe
Since 2010, we’ve also seen numerous versions of a federally proposed act (in both the House and the Senate), often called Keeping All Students Safe, introduced and then stalled in committee. Our country struggles to reach a consensus on this important issue. This lack of consensus occurs not just at the federal level, but at the state level as well.

One of my roles here at CPI is to monitor legislative and regulatory activity that affects our offerings or the organizations already using our offerings. I have to be honest and say that it’s sometimes difficult to be optimistic that our policy makers and our advocates are able to set aside personal agendas to reach consensus on issues of grave concern to all of us.

At the end of the day, we all share a common goal: We all believe that school should be a safe environment where children (and subsequently staff as well) can learn and can excel both academically and socially. We are compelled, rightfully so, to provide this environment for all children—not just those who are free from cognitive or physical disabilities, or free from mental health issues, or free from poverty or free from abuse and neglect—and my list could go on.

Reaching Consensus on the Meaning of Personal Safety
We are moving into an era where the bigger picture of school safety has been called to the front. We need to address this issue, but let’s not forget that violence starts interpersonally.

We must equip our staff with skills to defuse, de-escalate, and manage violent and aggressive behavior. We need to enable teachers to teach and students to learn in a safe environment that starts first with their personal safety.

But we need to reach a consensus on what that means. I’m puzzled by how individuals in Minnesota can call for an extension on implementing a prohibition on prone restraint that passed two years ago, when state after state has successfully implemented bans on prone restraint. I’m puzzled by how individuals in Maine can call for the language in their newly adopted Chapter 33 to be reversed so that physical restraint can be used to “prevent disruption of the educational environment” even in the absence of imminent danger, while most other regulations specifically restrict the use of physical restraint only to those moments when there is imminent danger of serious physical harm to self or others.

Discussing School Safety
Last week, Congressman John Kline, chairman of the House Education & the Workforce Committee, announced a hearing that will take place on February 27, 2013. The hearing, titled “Protecting Students and Teachers: A Discussion on School Safety,” is being convened to discuss school safety issues in the wake of the Sandy Hook Elementary School tragedy.

Kline stated, “We have a responsibility to examine what is and is not working when it comes to school safety. The upcoming hearing will provide an opportunity to discuss ways states and school districts are working to prevent violence in our classrooms.”

The focus of the hearing will be on preparing for and recovering from threats of violence. I hope we are better at reaching consensus on these issues than we have been on the issue of decreasing the use of restraint.

Reducing Hospital Violence
Finally, I would say that this issue of managing, preventing, and responding to workplace violence certainly extends past our school buildings. At times, it can be as disappointing a conversation in health care and mental health as it can be in education. That said, as I’ve mentioned before, I’ve seen and heard of some wonderful ways to make it all work. It is possible to meet the needs of staff, students, patients, and families—to balance everyone’s needs.

Come join us at ENA’s (Emergency Nurses Association) Leadership Conference (Booth #234) February 27–March 3 to talk about ways you can create a safer culture of care in your emergency department. CPI continues to strive to help organizations create safe environments of care and education that balance equally the Care, Welfare, Safety, and Security^SM of everyone.

Additional Resources

• Learn more about the “Protecting Students and Teachers: A Discussion on School Safety” hearing.
• Read an AASA (American Association of School Administrators) article that details the success of two districts that have reduced their use of restraint as a result of implementing Nonviolent Crisis Intervention^® training. While the AASA’s position on the federal bill differs from ours, I commend the organization for emphasizing that training can greatly reduce the need for physical intervention.
• Get helpful hints about behavior management.