Purpose
This study examined the prevalence, predictors, and patterns of mechanical restraint in an inpatient dual diagnosis population.

Design and Methods
Data were longitudinally collected from patients affected by severe mental illness and comorbid substance abuse that were hospitalized in three large wards from 2006 to 2012.

Findings
In a sample of 1698 hospitalizations, the use of mechanical restraint ranged between 1% and 4% per year. The diagnosis of schizophrenia (odds ratio [OR], 2.64; 95% confidence interval [CI], 1.29-5.40), the use of stimulant substances (OR, 5.68; 95% CI, 2.78-11.59) and male sex (OR, 3.22; 95% CI, 1.12-9.27) were associated with an increased risk of being exposed to mechanical restraint.

Practice Implications
Specialized interventions targeting people at risk of mechanical restraint may further reduce the incidence of restraint and improve treatment outcomes.