What is it about?

The Risk of Administrative Segregation Tool (RAST) was created to identify offenders at risk of prolonged segregation in Canadian correctional institutions. We tested whether it could identify psychiatric patients at risk of seclusion in forensic hospital. With some modifications, the RAST predicted seclusions in 1 to 2 years of hospitalization. We called the modified tool the RAST-F, and showed how it could be used when patients are admitted to hospital in order to identify at-risk patients.

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Why is it important?

For persons using inpatient psychiatric services, seclusion is coercive and potentially traumatizing. Poor use of seclusion has resulted in patient injuries and even death. There are widespread attempts to reduce seclusion use in hospitals. The ability to identify at-risk patients could aid efforts to reduce seclusion, if tied to other ways to proactively managing problematic behavior. The RAST-F shows promise as a tool to identify patients most in need of clinical efforts to avert seclusion.


I hope that the RAST will be used to identify at-risk patients, and that patients will be offered pro-active, psychological and behavioral therapies to help them manage their behavior and reduce their suffering.

Dr N Zoe Hilton
University of Toronto

Read the Original

This page is a summary of: Assessment of Risk for Seclusion Among Forensic Inpatients: Validation and Modification of the Risk of Administrative Segregation Tool (RAST), International Journal of Offender Therapy and Comparative Criminology, February 2019, SAGE Publications, DOI: 10.1177/0306624x18823621.
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