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Restraints are common across hospitals, schools, and juvenile justice settings. Oversight varies widely.

Black children and adults face disproportionately higher rates of restraint in emergency room settings.

Restraints traumatize, have caused deaths, and can drive patients of color away from care they need.

Families have the right to ask about restraint use and demand alternatives, including peer respite centers.

It was the summer of 2013, and I had just arrived in Haiti as part of a global mental health fellowship—an early-career psychiatrist fresh out of training, there to support community-based mental health services serving a community of 1.3 million people in rural Haiti. Within days of arriving, I was asked to help develop a policy for the use of physical restraints at a hospital.

The head of security showed me the equipment. I stood there looking at the straps, cuffs, and fasteners, and my stomach dropped. I was in a former slave colony, the first Black republic in the world, founded on a revolution against the literal shackling of human beings—60 years before emancipation transpired in the United States. And I was being handed what amounted to a contemporary version of shackles and asked to deploy them in the name of safety and treatment.

The discomfort I felt gave me something I hadn't been able to find in my American medical training: distance. Being an outsider, in a country that was not my own, with a history I could not look away from—it cracked something open. I began to ask a question I had never been permitted to ask in residency: Why are we claiming to seek safety in violence?

Back in the United States, during my intern year several years earlier, I had spent a month........

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