developmental age, size, gender, physical condition, medical condition, psychiatric
condition, and personal history, including any history of trauma, and done in a manner
consistent with the youth’s treatment plan.
(7) If a mechanical restraint is used, staff must use the permitted methods of mechanical
restraint and appropriate techniques for use of restraints, and the agency shall provide
guidance to staff in deciding what level of restraint to use if that becomes necessary.
(8) Restraint may not last longer than the minimal duration of time it takes for a youth to
regain self-control and to restore safety.
(9) Staff must continuously monitor the youth’s breathing and other signs of physical
distress and take appropriate action to ensure adequate respiration, circulation, and overall
(10) When an emergency health situation occurs or the youth exhibits sign of physical
distress during the restraint, staff must immediately obtain treatment for the youth.
(11) Written policies and notifications must be posted publicly in visiting areas and
provided in writing, in their entirety, to referral agencies and legal guardians.
R 400.4162 Seclusion within secure and nonsecure facilities; seclusion plan;
prohibitions; reduction and elimination.
Rule 162. (1) An agency must establish a process improvement and a seclusion
reduction/elimination plan that addresses the following areas:
(a) Requires staff training in approved crisis prevention and intervention techniques
(i) Prevention, de-escalation techniques, and non-violent response to assaultive behavior.
(ii) Conflict management.
(iii) Minimizing and addressing trauma for youth and staff.
(b) Training must be conducted by certified trainers.
(c) Staff shall complete refresher training annually or more frequently as needed.
(d) Access to youth support team members.
(e) Review and update the youth’s individual behavioral and calming plan, as needed.
(2) Prior to using seclusion, staff must use less restrictive techniques to de-escalate the
situation such as talking with youth, bringing in other staff or qualified mental health
professionals to assist, or engaging family members or other youth to talk with the youth. Prior
to using seclusion or immediately after placing a youth in seclusion, staff will explain to the
youth the reasons for the seclusion and the fact that he or she will be released upon regaining
(3) Seclusion must be performed in a manner that is safe, appropriate, and consistent with the
youth’s chronological and developmental age, size, gender, physical condition, medical
condition, psychiatric condition, and personal history, including history of trauma.
(4) Staff must only use seclusion as a temporary response to prevent life-threatening injury or
serious bodily harm when other interventions are ineffective.
(5) Staff may not use seclusion for discipline, punishment, administrative convenience,
retaliation, staffing shortages, or reasons other than a temporary response to behavior that
threatens immediate harm to a youth or others.
(6) Staff may not place youth in seclusion for fixed periods of time. Staff must release the
youth from seclusion as soon as the youth has regained self-control and is no longer engaging
in behavior that threatens immediate harm to the youth or others.
(7) During the time that a youth is in seclusion, staff must perform variable interval, eye-on
checks of youth. The time between the variable interval checks must not exceed 15 minutes