1. (1) Seclusion or restraint may only be used on a patient to ensure the imminent physical safety of the patient or others. Neither seclusion nor restraint will be used as a means of coercion, discipline, convenience, or retaliation by staff.
2. (2) Seclusion or restraint must be discontinued at the earliest possible time, regardless of the length of time identified in the seclusion or restraint order. At minimum, the patient must be released as soon as a trained physician, nurse practitioner or registered nurse determines that, if released, the patient will not imminently pose a physical danger to the patient or others.
3. (3) OSH must provide initial and ongoing training on seclusion or restraint to OSH Staff who have direct patient care responsibilities, consistent with hospital policy.
4. (4) Patients must not be permitted to use restraint on other patients.
5. (5) Medication will not be used as a restraint but will be prescribed and administered according to acceptable medical, nursing, and pharmaceutical practices.
6. (6) Restraint must be used in accordance with sound medical practice to assure the least risk of physical injury and discomfort. Any patient placed in restraint must be protected from self-injury and from injury by others.

7. (7) OSH must use the least restrictive, most appropriate intervention that will be effective to protect the patient or others from harm. The determination of the most appropriate intervention requires consideration of at least the following factors:

   1. (a) The patient involved (e.g., the present physical ability to engage in violent or destructive behavior and the patient’s reaction to various methods of intervention);
   2. (b) The patient’s or legal guardian’s preference under section (8) of this rule;
   3. (c) The risk or degree of physical or psychological harm and discomfort that accompany the various methods of restraint;
   4. (d) The risk or degree of interference with the individual’s ongoing treatment; and
   5. (e) Whether less restrictive interventions will be ineffective to protect the patient or others from harm.

8. (8) Preference of Patient and Legal Guardian:

   1. (a) Whenever the interdisciplinary team (IDT) has reason to believe that in the course of a patient’s care, custody, or treatment at a state institution it may become necessary to use seclusion or restraint, a member of the IDT must, if practicable, ask the patient for an expression of preference or aversion to the various forms of intervention. If there is a legal guardian, a member of the IDT must also ask the legal guardian for an expression of preference regarding forms of restraint. The patient’s expression, if any, as well as that of guardian must be relayed to the other IDT members and recorded in the patient’s medical record; and
   2. (b) The patient’s or legal guardian’s preferences for or against particular forms of restraint must be respected by the individual authorizing the use of seclusion or restraint, provided that primary consideration must be given to the need to protect the patient and others in the institution. If possible, both the patient’s and legal guardian’s preferences should be taken into consideration. If there is a conflict between the patient’s and the legal guardian’s preferences, the legal guardian’s preference will prevail.
9. (9) A summary of all uses of seclusion or restraint must be sent to the chief medical officer at least monthly.
10. (10) A patient, guardian, or a duly authorized representative of the patient has the right to contest any application of these rules as provided in OAR 309-118-0000 through 309-118-0050 (Grievance Procedures for Use in State Institutions).
11. (11) Violation of the rights, policies, and procedures set forth in these rules by staff at the state institution constitutes cause for disciplinary action.

Statutory/Other Authority

ORS 179.040, 413.042 & 179.360

Statutes/Other Implemented

ORS 426.385 & 179.360

History

BHS 25-2025, amend filed 12/22/2025, effective 12/29/2025
BHS 19-2025, temporary amend filed 07/03/2025, effective 07/03/2025 through 12/29/2025
BHS 16-2022, amend filed 08/11/2022, effective 08/11/2022
BHS 6-2022, temporary amend filed 04/12/2022, effective 04/12/2022 through 10/08/2022
BHS 11-2020, amend filed 09/22/2020, effective 09/23/2020
BHS 5-2020, temporary amend filed 04/20/2020, effective 04/20/2020 through 10/16/2020
MHS 2-2016, f. & cert. ef. 4-21-16
Reverted to MHD 2-1986, f. & ef. 3-31-86
MHS 6-2015(Temp), f. 10-20-15, cert. ef. 10-21-15 thru 4-15-16
Reverted to MHD 2-1986, f. & ef. 3-31-86
MHS 2-2013(Temp), f. & cert. ef. 1-23-13 thru 7-19-13
MHD 2-1986, f. & ef. 3-31-86
MHD 16-1985(Temp), f. & ef. 10-9-85
MHD 1-1984, f. 1-20-84, ef. 2-1-84
MHD 21-1982, f. & ef. 9-24-82
MHD 11-1982(Temp), f. & ef. 6-10-82
MHD 7-1982, f. & ef. 3-29-82
MHD 1-1982(Temp), f. & ef. 1-14-82