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Is there an alternative to seclusion or mechanical restraint?

Sir: The treatment of agitated patients has been reviewed in the literature.1 We would like to comment on the use of restraints and seclusion for such patients. We agree that mechanical restraints or seclusion should be the last measure used in the majority of cases, but think that application of such methods is sometimes necessary. A decline in the use of seclusion or mechanical restraint due to administrative regulation might be dangerous and the reason for increased violence on psychiatric wards.2 Furthermore, some patients have been known to request placement in seclusion3 or to be mechanically restrained. Although significant literature exists, there is a lack of knowledge about patients' attitudes toward these methods independent of personal experiences.