By Police1 Staff
In September 2024, the Police Executive Research Forum (PERF) released a report providing new guidelines aimed at reducing restraint-related deaths, an issue that continues to be at the forefront of discussions surrounding police use of force.
“15 Principles for Reducing the Risk of Restraint-Related Death” addresses critical practices and response strategies when police are required to restrain individuals, especially those experiencing medical or behavioral emergencies. (The report is available in full below.)
Recent incidents and high-profile cases, such as those involving Elijah McClain in Aurora, Colorado, and George Floyd in Minneapolis, have intensified scrutiny around restraint techniques and highlighted the need for officers to effectively balance safety and medical needs in these situations. The new guidance from PERF aims to address these concerns, offering actionable steps to prevent fatalities while handling such cases.
The report results from a June 2024 meeting, convened with support from the Howard G. Buffett Foundation, where a group of experts — including cardiologists, emergency medical professionals and law enforcement practitioners — gathered to discuss and develop a consensus on best practices. Topics included effective restraint techniques, recognizing medical-behavioral emergencies and ensuring collaboration with emergency medical services (EMS).
Some of the principles detailed in the report include:
- Identification of medical-behavioral emergencies: Emphasizing the importance of viewing individuals in distress as patients requiring medical care.
- ICAT (Integrating Communications, Assessment, and Tactics) principles apply to medical-behavioral emergencies: Officers should employ the Critical Decision-Making Model and the principles of time, distance, and cover.
- De-escalation and coordination with EMS: Encouraging de-escalation tactics and coordinated response between law enforcement and EMS professionals.
- Minimizing the use of prone restraints: Limiting prone restraints to allow subjects to breathe freely and reduce risks.
- Establishing supervisory roles: Recommending clear supervisory and patient safety roles on the scene to monitor subjects’ safety and well-being during incidents.
- The goal is control, NOT complete immobilization: A controlled subject does not need to be completely immobile — repeatedly demanding that a restrained person “stop moving” is counterproductive and dangerous.
- The ability to speak does not mean a person can breathe: A person can talk and still be in physiological distress, so statements about trouble breathing must be taken seriously.
PERF hopes that law enforcement agencies across the country will adopt these guidelines to improve outcomes in restraint-related situations and help build community trust by demonstrating a commitment to safety and professionalism.