How to Ask a Rehab Centre About Restraint and Seclusion Policies

Meena has the admissions coordinator on speakerphone. Her brother has been drinking heavily for three years, and she has already asked about fees and visiting hours. One question on her notepad is underlined twice, and she keeps not asking it: “What do you do if he gets violent or tries to leave?” That question is really about the centre’s rehab restraint and seclusion policy.

She worries it will sound like an accusation, so she thanks the coordinator and hangs up. Many families do exactly this. This guide is for the moment before you hang up: what Indian law requires, and the exact questions, in five rounds, to find out whether a centre follows it.

Quick answer: Under Section 97 of the Mental Healthcare Act 2017, seclusion and solitary confinement are banned. Physical restraint is allowed only as a last resort to prevent imminent harm, must be authorised by the treating psychiatrist, kept as short as possible, recorded in the notes, reported to the family within 24 hours and to the Review Board monthly. Ask the centre to explain each step.

Why the restraint question matters in de-addiction care

People in early recovery can be confused, frightened or agitated, especially during withdrawal. Someone in severe alcohol withdrawal may hallucinate; someone just admitted may be furious with the family. A responsible centre plans for these situations. Some poorly run centres instead treat agitation as misbehaviour, and news reports over the years have described patients in so-called nasha mukti kendras being tied up, locked in rooms or kept sedated for days.

Asking about restraint is therefore not an insult. It is like asking about fire exits. A good centre will have written it down and trained its staff. A centre that has not thought about it is telling you something important.

Section 97 explained: the legal base of a rehab restraint and seclusion policy

The Mental Healthcare Act 2017 (MHCA) covers mental health establishments, and its definition of mental illness includes conditions linked to alcohol and drug use, so de-addiction centres fall under it. Registration itself is required under Section 65 on registering mental health establishments, and our guide on how to verify a rehab centre’s registration explains how to check it.

The rules on restraint sit in Section 97 of the Mental Healthcare Act on restraints and seclusion. In plain language, it says the following.

• Seclusion and solitary confinement are not allowed. Not “rarely”; the Act prohibits them.
• Physical restraint is a last resort. It can be used only when no other method can prevent imminent and immediate harm to the person or to someone else.
• The treating psychiatrist must authorise it. The psychiatrist in charge of that person’s treatment at the establishment is the one who can approve it, not a warden, counsellor or security guard.
• It must be as short as possible. Restraint can last only as long as it is absolutely needed to prevent an immediate risk of significant harm.
• It must be recorded. The method, nature, reason and duration have to be written promptly into the person’s medical notes.
• It cannot be punishment. Restraint must never be used as a penalty or a deterrent, and a centre cannot use it because it is short of staff.
• The nominated representative must be told within 24 hours. Every instance of restraint has to be reported to the person’s nominated representative.
• The person must be kept safe and watched. A restrained person must be in a place where they cannot harm themselves or others, under regular and continuous supervision by medical staff.
• Every instance goes to the Board. The establishment must include all restraint episodes in a monthly report to the Mental Health Review Board.
• The Board can stop a centre using restraint. If a centre persistently and wilfully ignores these rules, the Board can order it to stop using restraint altogether.

Two other parts of the law matter here. Section 20 on protection from cruel, inhuman and degrading treatment lists protections inside any mental health establishment: a safe and clean living space, privacy, enough clothing, nutritious food, protection from forced head-shaving, freedom from being forced to wear uniforms, no compulsory work (and fair pay for any work done), and protection from physical, verbal, emotional and sexual abuse.

For the clinical side, a useful reference is the restraint guidelines for Indian mental health services published in the Indian Journal of Psychiatry. It describes restraint as a last resort, separates physical restraint from chemical restraint, and covers practical safeguards such as close observation, avoiding face-down holds and releasing the person as soon as the danger passes.

Before you start: how to use the five rounds

You do not need to ask all five rounds in one call. Many families ask Rounds 1 and 2 on the phone and cover the rest during a visit. Our rehab facility tour checklist pairs well with Rounds 3 and 4, because some answers are easier to check with your own eyes.

Together, the five rounds cover every part of a sound rehab restraint and seclusion policy. No answer will match the tables word for word. Listen for the pattern: specifics, names, records and limits are good; vagueness, jokes and “don’t worry” are not.

Round 1: Does the centre use restraint at all, and what comes first?

Start broad. A centre that says “never, ever” may be honest, or may simply have no plan. One that says “rarely, and here is our process” is often the more trustworthy.

What to ask	A reassuring answer sounds like	A worrying answer sounds like
“Have you ever needed to physically restrain a patient here?”	“Rarely, and only when someone was about to hurt themselves or others. We follow the Mental Healthcare Act process.”	“Sometimes we have to be strict with these people.” Or a flat “never” with no explanation of what happens instead.
“What do staff try before any restraint?”	Talking calmly, giving space, involving a familiar counsellor, reducing noise, offering a call with family, a doctor’s review of withdrawal symptoms.	“Our boys handle it.” Or “We give a dose and he sleeps.”
“Are staff trained in de-escalation?”	Names the kind of training, who gives it and how often it is refreshed.	“Everyone knows how to manage patients.” No training described.
“What if he becomes agitated on the first night because of withdrawal?”	Links agitation to medical assessment, describes doctor or nurse response and when they would transfer to hospital.	Treats it as a discipline issue rather than a medical one.

The withdrawal question is especially telling. Agitation in the first days is often medical, not behavioural. A centre with a proper medically supervised detox programme should be able to explain how it manages severe withdrawal so that restraint becomes less likely. If your relative may arrive drunk or high, read our note on entering rehab while intoxicated and ask how that first night is handled.

Also listen for “patients” versus “these people” or “addicts”. How staff talk about residents often predicts how they treat them under pressure.

Round 2: Who authorises physical restraint in rehab, and for how long?

The law names the treating psychiatrist as the one who authorises physical restraint. So the practical question is whether a psychiatrist is reachable at 2 a.m. on a Sunday. If they visit twice a week and are otherwise unreachable, the process exists only on paper.

What to ask	A reassuring answer sounds like	A worrying answer sounds like
“Who decides that restraint is needed?”	“Only the psychiatrist treating the patient can authorise it. Nurses can call them any time.”	“The in-charge decides.” Or “Senior staff take a call.”
“How is the psychiatrist contacted at night?”	A clear on-call arrangement with a named doctor, and what happens if they cannot be reached.	“We manage, sir sees him in the morning.”
“How long can restraint last?”	“Only until the immediate danger passes. Someone checks continuously and we release as soon as it is safe.”	“Till he calms down.” Or a fixed number of hours regardless of behaviour.
“Who watches the person while they are restrained?”	A nurse or doctor stays with them or checks very frequently, and records observations.	“He is in his room, we look in.”

Our posts on night-time medical cover in rehab and the roles of psychiatrists, psychologists and counsellors will help you judge whether the answer is realistic. A counsellor, however experienced, cannot authorise restraint.

Ask about the method too. The Indian Journal of Psychiatry guidelines note that the MHCA rules out metal handcuffs, shackles and chains. If anyone mentions ropes, chains, locks on limbs or tying someone to a bed frame with cloth, treat that as a serious red flag.

Round 3: Records, family notification and patient rights in rehab

This round tests whether the earlier answers are backed by paper. A centre that genuinely records, notifies and reports each episode will usually talk about it without hesitation.

What to ask	A reassuring answer sounds like	A worrying answer sounds like
“If restraint is used, how and when will we be told?”	“The nominated representative gets a call within 24 hours, usually much sooner, and it is noted that we informed you.”	“We only call families if it is serious.” Or “Why would you need to know?”
“What gets written down?”	Method, reason, duration, who authorised it, observations during the episode.	“The staff will remember.” Or “We keep a register somewhere.”
“Do you report restraint to the Mental Health Review Board?”	“Yes, monthly, as the Act requires.” May mention who prepares the report.	Has not heard of the Board, or says the rule does not apply to de-addiction centres.
“Can we see the record if it happens?”	“Yes, the patient and nominated representative can request copies of the notes.”	“Records are internal.” Or a promise followed by refusal later.

On records, the draft Charter of Patients’ Rights circulated by the Health Ministry lists a right to records and reports, and a right to be heard and seek redress. It is a draft charter rather than a law in itself, but it reflects a widely accepted standard: patients and their caregivers should be able to see what was written about their care.

Clarify before admission who the nominated representative will be. An adult patient can choose someone; if none is chosen, it is often a relative or caregiver. If that person lives abroad, agree on a second contact. A written treatment plan is a good place to record who should be informed about what.

Round 4: Rooms, locks and “time-out” rooms (seclusion by another name)

Few centres will say “we use seclusion”. You may hear “quiet room”, “observation room”, “time-out room” or “cooling-off room” instead. Some are legitimate, such as an open sitting area with staff present. Others are a locked room by another name.

The test is simple: if a person is placed alone in a space they cannot leave, that is what the ban on seclusion is meant to stop. So, is it legal to lock a patient in rehab? A locked main gate is a separate safety question, but locking one person alone in a room is not something a responsible centre should do.

What to ask	A reassuring answer sounds like	A worrying answer sounds like
“Do you have a separate room for patients who are upset or aggressive?”	“There is a quiet space, but the door is not locked and a staff member stays with them.”	“Yes, we keep them there until they settle.” Or “It is for their own good.”
“Can patient rooms be locked from outside?”	“No.” Or a clear safety reason with staff present and no one locked in alone.	“Only at night.” Or “Only for new patients for the first few days.”
“Can we see that room during our visit?”	“Of course.” They show it without fuss.	“It is under maintenance.” Or “Patients are resting, not today.”
“What is ‘time-out’ here, exactly?”	A pause from a group activity, a walk with a counsellor, a talk in an open space.	Being shut in a room, kept away from others for hours or days, no phone, no visitors.

When you visit, look at the doors. Bolts on the outside of bedrooms? A room staff seem reluctant to open? Note it and ask later. A new centre may not have thought this through yet; our list of questions to ask a newly opened rehab centre includes ways to check whether written policies exist beyond the brochure.

Round 5: Chemical restraint, sedation and punishment practices

This round covers two things families find hardest to raise. First, chemical restraint in rehab: medication used to control behaviour rather than treat a condition. Second, punishments such as head-shaving, forced labour, denial of food or being locked away.

Detox often needs sedating medicines, prescribed and monitored by a doctor. The concern is medication given mainly to keep someone quiet, without clinical reason, documentation or review, which is the line the Indian Journal of Psychiatry guidelines draw too.

What to ask	A reassuring answer sounds like	A worrying answer sounds like
“How do you decide on sedating medicines during detox?”	“The doctor prescribes based on withdrawal assessment, reviews the dose regularly and tapers it.”	“We give injections when needed so they don’t create problems.”
“Will we be told if extra or emergency medication is given?”	“Yes, and it goes in the notes with the reason. We can explain it to you.”	“That is our medical decision, families don’t need details.”
“What happens when a patient breaks a rule?”	A conversation, a review with the counsellor, adjusting the plan, involving family if needed.	Extra work duties, loss of meals, head-shaving, being made to stand, “punishment room”.
“Do patients do cleaning or kitchen work?”	Light shared chores as part of daily routine, chosen and reasonable, never as punishment.	Patients do the centre’s cleaning, cooking or construction instead of paid staff.

Section 20 of the MHCA specifically protects people in mental health establishments from forced head-shaving and from being compelled to work. The UNODC-WHO International Standards for the Treatment of Drug Use Disorders go further in spirit: they say treatment should not be forced against a person’s will and that punitive, humiliating or degrading interventions should never be used.

If your relative also has depression, psychosis or past trauma, ask how the centre adjusts. People with a history of abuse can be badly affected by being held down. Centres offering a dual diagnosis treatment programme or trauma-informed therapy should be able to say how they reduce that risk in practice.

How to ask without sounding accusatory

The awkwardness comes from imagining the question implies “I think you abuse people”. It does not. Frame it as understanding their process, the way you would ask a hospital about infection control. Try phrasings like these.

• “We have read that the Mental Healthcare Act has rules on restraint. Could you walk me through how you follow them?”
• “My brother can get angry when he is withdrawing. What would your team do if that happened at night?”
• “I’m asking every centre the same questions, so please don’t take this personally. Do you ever need to restrain someone?”
• “If something like that happened, who would call me, and how soon?”
• “Is there a written policy I could read before we decide?”
• “During the visit, could we see all the rooms, including any quiet or observation room?”

These mention the law, which signals you are informed, and describe your relative specifically, which makes the question practical. They ask for process, not confession.

Avoid opening with news stories about other centres; you will get a defensive answer. Don’t accept “we are a family here, nothing like that happens” as the end; gently repeat the specific question. Warmth on the phone is pleasant, but it is not a policy.

You can ask us the same questions. At Second New Life, we would rather families ask openly before admission than worry silently afterwards, and the same goes for any centre you are considering.

Reading the written rehab restraint and seclusion policy

If the centre shares a written policy, read it with the five rounds in mind. It need not be long, but it should be specific. Look for these points.

1. A clear statement that seclusion is not used.
2. Conditions for restraint. It should say restraint is used only to prevent imminent harm and only when other methods have failed or would not work.
3. De-escalation steps. What staff try first, in what order.
4. Authorisation. The treating psychiatrist, named by role, and how they are contacted out of hours.
5. Methods allowed and not allowed. No chains, ropes or handcuffs; avoidance of face-down holds.
6. Observation and release. Who watches, how often notes are made, when the person is released.
7. Records and reporting. Notes, family notification within 24 hours, monthly Board reports.
8. Debriefing and review. Talking with the patient afterwards and reviewing what could have prevented the episode.
9. Medication. How emergency or extra sedation is decided, recorded and reviewed.
10. Prohibited practices. No punishment, no forced work, no head-shaving, no withholding of food or contact as a penalty.

Compare the document with what you were told on the phone. If the coordinator said “never” and the policy describes regular use, or the policy is a downloaded template with another centre’s name still in the footer, that tells you how seriously it is taken. Our guide to warning signs in rehab advertisements covers similar gaps between promises and practice.

Finally, ask how the centre decides when an agitated patient needs a hospital rather than restraint. Our post on a rehab emergency transfer plan explains what that should look like.

If your relative says they were restrained or locked in

Sometimes the question comes after admission. Your relative says, in a rushed call or after discharge, that they were tied down, locked in a room or given an injection that knocked them out. Here is a calm, step-by-step response.

1. If anyone is in immediate danger, call 112

If your relative says they are being harmed right now, cannot leave a locked room, are injured or are being threatened, call 112. You can also go to the centre with another family member. Do not wait for the centre to “explain” first.

2. Write it down straight away

Note the date, time, what your relative said, who was involved and any injuries. Save call logs and WhatsApp messages. If your relative agrees, photograph any marks. Same-day notes carry weight later.

3. Ask the centre for the records

Ask, preferably in writing, for the medical notes about the incident: whether restraint or emergency medication was used, who authorised it, how long it lasted and when the nominated representative was informed. Under Section 97 these details should exist. If the centre says there is nothing on record, that itself is significant.

4. Use the nominated representative’s role

The nominated representative has duties under Section 17 of the Mental Healthcare Act, including seeking information about diagnosis and treatment and approaching the Mental Health Review Board if the person’s rights are being violated in an establishment. If you are that person, you are not just “the family”; you have a defined role.

5. Complain to the Board and the State Mental Health Authority

The Mental Health Review Board for your district or region can hear complaints about rights violations, and the State Mental Health Authority handles registration of establishments. In Delhi NCR, that means the authority for the state where the centre is located, such as Delhi, Uttar Pradesh or Haryana. You can also raise the matter with the centre’s registering authority under the Clinical Establishments framework where it applies.

6. Plan a safe move if needed

If you lose trust in the centre, you can arrange a transfer. Do it in a planned way so that withdrawal or medication is not interrupted. Our guide on changing rehab centres mid-treatment covers handover of records and medicines.

For support while you work this out, Tele-MANAS (14416) and the national de-addiction helpline (14446) are available. A single episode, properly authorised, recorded and reported, may have been lawful and necessary. The aim is to find out whether the law was followed.

Frequently asked questions about restraint and seclusion in rehab

Is seclusion allowed in a de-addiction centre in India?

No. Section 97 of the Mental Healthcare Act 2017 prohibits seclusion and solitary confinement for people with mental illness, and the Act’s definition covers conditions linked to alcohol and drug use. A registered de-addiction centre should not lock a person alone in a room, whatever name the room is given, such as “time-out” or “observation”.

When is physical restraint in rehab legal?

Only when no other method can prevent imminent and immediate harm to the patient or others, and only when the treating psychiatrist authorises it. It must last no longer than absolutely necessary, be recorded in the medical notes, be reported to the nominated representative within 24 hours, and appear in the centre’s monthly report to the Mental Health Review Board.

What is chemical restraint, and how is it different from detox medication?

Chemical restraint means giving medicine mainly to control behaviour rather than to treat a medical condition. Detox medicines, by contrast, are prescribed to manage withdrawal safely, with doses assessed and reviewed by a doctor. Ask the centre how sedation decisions are made, documented and explained to the family, and whether you will be told about emergency doses.

Can a rehab centre shave a patient’s head or make them do labour?

Section 20 of the Mental Healthcare Act protects people in mental health establishments from forced head-shaving and from being compelled to work, and says any work done must be fairly paid. Light shared chores chosen as part of a routine are different from punishment duties or doing the centre’s cleaning and cooking in place of staff.

Who should the centre inform if my relative is restrained?

The law says the nominated representative must be informed of every restraint within 24 hours. This is usually the person your relative has chosen, or, if none was chosen, often a relative or caregiver. Confirm before admission who that person is, and give the centre a backup contact in case they cannot reach you.

What should I do if I think my relative was restrained illegally?

If there is immediate danger, call 112. Otherwise, write down what you were told, save messages, and ask the centre in writing for the medical records of the incident. The nominated representative can approach the Mental Health Review Board about rights violations, and you can also contact the State Mental Health Authority where the centre is registered.

One question worth the awkward pause

If Meena had asked her underlined question, the answer would have told her more than the brochure and fee sheet combined. A calm, specific reply with names, records and limits is a good sign. A laugh or a change of subject is not.

You are allowed to ask. You are allowed to ask twice. If you would like to talk through these questions, or put them to our team directly, you can contact Second New Life or call +91 84481 77994.