Forensic Review of Restraint and Seclusion Events in New York Psychiatric Care

Stephan M. Carlson, MD, MBA, FAPA · Psychiatric Malpractice

Restraint and seclusion are among the few clinical acts that double as restrictions of liberty, which is why New York regulates the order, the indication, and the clock with unusual precision. A forensic review succeeds or fails on whether it measures the event against that regulatory frame rather than against the outcome. The standard New York actually imposes In New York, a restraint or seclusion episode is governed by the Mental Hygiene Law and the Office of Mental Health regulation that operationalizes it. Section 33.04 treats restraint as a restriction on a patient's rights, and 14 NYCRR 526.4 sets the mechanics: restraint or seclusion may be used only to prevent imminent, serious injur

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