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The security of a straitjacket depends very much on its size, which should be as small as practicable to be secure.  That is not really that important since you will just imagine that you are wearing it.  A jacket that is tight at the chest and armpits will make it much more difficult for the wearer to pull the arms out of the sleeves.

The sleeves of the jacket are typically sewn shut at the ends—a significant restraint in itself because it restrains the use of the hands.

The big challenge here is that you can't scratch an itch or pick your nose. The arms are then folded across the front, with the ends of the sleeves wrapping around to fasten or tie behind the back. On some jackets, the sleeve-ends are not anchored to the garment to allow the fastening or knot to rotate away from the wearer's hands as they move their arms, making it more difficult to undo. Some straitjackets are even designed to have the person's arms crossed behind him/her rather than in front to ensure restraint even more.

Most jackets feature a crotch-strap to prevent the jacket from simply being pulled up and off. Some sport loops at the front and/or sides; the sleeves are threaded through these to prevent the arms from being raised over the head. Friction buckles are commonly used to fasten institutional jackets with webbing or cloth straps because they are very difficult to open without a free pair of hands.