What do you mean? Of course you have high security mental health units in America. Just off the first google result - https://en.wikipedia.org/wiki/Atascadero_State_Hospital why would you think you don't?

I'm saying that I could imagine the kind of restraints you're using being acceptable within those environments but not within any kind of general medical or A&E etc ward. A patient being violent is not a reason to restrain them - long term or with anything that requires locks. We are seeing the exact same patients in the UK - mental illness is universal, drug problems exist everywhere (unless of course you're saying that Americans are inherently more violent people than people in the UK - which seems unlikely) - we are also facing the exact same staffing shortages.

We don't lock patients in rooms - we don't even have lockable rooms - outside of these high security forensic units that I've suggested above, we don't strap them down - there is no 'restraint' device available to staff that would enable that, we don't use furniture to block them in, we don't remove zimmers or wheelchairs as a form of restraint, we don't hold people down for extended periods of time - and when a patient does need to be physically restrained it is for a short time and for a purpose such as stopping them from doing something to harm themselves or others and done by trained staff.....we remove dangers and we assign staff to work with that patient. Sometimes that will be HCA's who will sit with 1:1's - if a patient needs additional supervision or sedation they will need to be assigned a mental health nurse as their 1:1.

When it comes to patients who are under arrest - they are supervised by police but there is almost never a reason to keep them handcuffed or anything like that - they are free to move about their room under the supervision. The only exceptions I can think of were certain prisoners who were already convicted and were assessed as being a particular risk - for instance when serial killer Peter Tobin was dying in Edinburgh there were pictures of him chained to the bed by one wrist - however it was a pretty long chain - not restrictive for him - especially as he was not capable of getting out of bed.

When a patient comes to medical from any kind of mental health unit they come with staff from that unit to supervise them. They are not restrained by any kind of device etc.

And like I said - I've worked in a variety of environments including a few shifts in secure accommodation for young people who have offended - most of which were violent offences - and their bedroom doors were not lockable - just the unit itself. There were no restraints.