(PS4-C54) The Intersection Between Staff and Resident Race and Gender in Physical Restraint Incidents

Friday, November 18, 2022

1:30 PM – 2:30 PM EST

Location: Westside Ballroom, 5th Floor

Author(s)

KB

Katherine R. Braund, B.S.

Student
Penn State Erie, The Behrend College
Erie, Pennsylvania

Co-Author(s)

JB

Jaclyn M. Burprich, None

Student
The Pennsylvania State University
Hermitage, Pennsylvania
HW

Heather Wimmer-Haman, Psy.D.

Psychologist
Sarah Reed
Erie, Pennsylvania
SB

Shelby Burton, Other

Psychologist
Sarah Reed
Erie, Pennsylvania
SS

Stacy Alaina. Stewart, M.A.

Psychologist
Sarah Reed
Erie, Pennsylvania

Author(s)

Wilson J. Brown, Ph.D.

Assistant Professor of Clinical Psychology
Penn State Erie, The Behrend College
Erie, Pennsylvania

Previous research identifies resident race and gender as predictors for restraint incidents in psychiatric residential treatment facilities (PRTFs), where racial minorities and boys are more at risk for restraint than their white counterparts and girls (Braun et al., 2020; Matte-Landry & Collin-Vézina, 2020; Brown et al., 2022). Racial disparities in restraint incidents observed in the extant literature raise concerns about the potential overapplication of physical restraint by staff members among Black or Biracial youth and the factors that maintain these discrepancies. However, research has yet to examine the intersection between resident race and gender and that of staff members who initiate restraints in PRTFs. The current study examined race and gender of staff members and residents as potential predictors of both restraint occurrence (i.e., whether the resident experiences at least one restraint during their care) and restraint frequency. The current study included residents (N = 150; 55.3% female, 66.7% White, 33.3% Black or Biracial) aged 6–17 (M = 11.8 years) admitted in a PRTF in the northeastern United States and staff members within this organization (N = 133; 49.6% female, 63.9% White, 30.8% Black or Biracial). Logistic and multiple regression analyses were conducted to investigate relationships between resident predictors of interest (i.e., race, gender) and restraint occurrence and frequency, respectively. Two-way ANOVAs were utilized to examine the effect of staff gender (male, female) and race (White, racial minority) on restraint frequency across residents by race and gender. The logistic regression analysis was significant (Χ²[3] = 45.85, p < .001, Nagelkerke R²= .355), correctly classifying 72.0% of cases. After controlling for length of stay, boys were 3.28 times more likely to experience restraint than girls, and Black or Biracial youth were 2.90 times more likely to experience restraint than White youth. While the multiple regression model for restraint frequency was significant (F[4,145] = 6.65, p < .001, R² = .155), neither race (β = .02, p = .78) nor gender (β = -.17, p = .06) of residents were significant predictors within the model. Notably, all two-way ANOVA models were not significant; that is, staff race and gender were not significant factors in the restraint of residents of different races and genders. While Black and Biracial youth are restrained at approximately the same frequency of White youth, Black and Biracial youth are more likely to be restrained than not in PRTFs. Additionally, staff race and gender do not appear to play a role in this disparity. Follow-up analyses will explore potential differences in clinical variables at intake that may offer further explanation of the lower threshold for restraint application in Black and Biracial youth.