65 Voluntary patients should only be restrained with their consent. If the application of restraint to a voluntary patient is deemed necessary and the patient disagrees, the legal status of the patient should be reviewed. 44. What can be done to prevent the misuse or overuse of means of restraint? First of all, experience has shown that in many psychiatric establishments the use of, in particular, mechanical restraint can be substantially reduced. Programmes set up in some countries for that purpose seem to have been successful, without this having led to an increased resort to chemical restraint or manual control. The question therefore arises whether complete (or almost complete) eradication of mechanical restraint might not be a realistic goal in the longer term. It is imperative that every single case of resort to means of restraint be authorised by a doctor or, at least, brought without delay to a doctor’s attention in order to seek approval for the measure. In the CPT’s experience, means of restraint tend to be applied more frequently when prior blanket consent is given by the doctor, instead of decisions being taken on a case by case (situation by situation) basis. 45. When the emergency situation resulting in the application of restraint ceases to exist, the patient should be released immediately. On occasion, the CPT encounters patients to whom mechanical restraints have been applied for days on end. There can be no justification for such a practice, which in the CPT’s view amounts to ill-treatment. One of the main reasons why such practices linger on is that very few psychiatric establishments have developed clear rules on the duration of periods of restraint. Psychiatric establishments should consider adopting a rule whereby the authorisation of the use of a mechanical restraint lapses after a certain period of time, unless explicitly extended by a doctor. For a doctor, the existence of such a rule will act as a powerful incentive to visit the restrained patient in person and thus verify his/her state of mental and physical well-being. 46. Once means of restraint have been removed, it is essential that a debriefing of the patient take place. For the doctor, this will provide an opportunity to explain the rationale behind the measure, and thus reduce the psychological trauma of the experience as well as restore the doctor-patient relationship. For the patient, such a debriefing is an occasion to explain his/her emotions prior to the restraint, which may improve both the patient’s own and the staff’s understanding of his/her behaviour. The patient and staff together can try to find alternative means for the patient to maintain control over himself/herself, thereby possibly preventing future eruptions of violence and subsequent restraint.