BACKGROUND In the Netherlands, seclusion is historically the measure of first choice in dealing with aggressive incidents. In 2010, the Mediant Mental Health Trust in Eastern Netherlands introduced a policy prioritising the use of enforced medication to manage aggressive incidents over seclusion. The main goal of the study was to investigate whether prioritising enforced medication over seclusi...

Background Seclusion continues to be a widespread measure used in psychiatric settings. Furthermore, the humanitarian, ethical and legal issues associated with the use of seclusion make it one of the most controversial management strategies available. Despite these important issues, little nursing research has sought to gain an understanding of the nurses' decision-making process regarding the ...

Several states and providers have embarked on initiatives to reduce using restraint and seclusion in residential programs. Restraint and seclusion are associated with harm to youth and staff, significant costs, reduced quality of care, and less engagement of youth and families. Successful reduction/prevention strategies have been identified, implemented, and reported. Both states and residentia...

Evaluate the innovations of no seclusion and restricted access to Psychiatric Intensive Care Units (PICUs) by: 1. Assessing the outcomes of (a) PICU transfer versus continued acute inpatient care among patients admitted to general adult wards, and of (b) seclusion versus no seclusion among PICU patients, in terms of: (i) repeated physical violence to others, injury to staff or patients, abscond...

Based on a modified grounded theory approach, in this study, we sought to elucidate the nursing care process used to guide psychiatric inpatients in long-term seclusion towards release from seclusion. Participant observations and interviews were conducted with a total of 18 nurses from three long-term psychiatric wards at two institutions from September 2011 to November 2012, to collect data on...

BACKGROUND The authors of a recent systematic review concluded that the use of non-pharmacological containment methods, excluding restraint and seclusion, was not supported by evidence. Their focus on randomised, controlled trials, however, does not reflect the research that has been, or could be, conducted. AIMS To find empirically supported interventions that allow reduction in the use of s...

BACKGROUND Involuntary medication in psychiatric treatment of inpatients is highly controversial. While laws regulating involuntary medication have been changed in Germany, no data have been available to date on how often involuntary medication is actually applied. Recently, our hospital group introduced specific routine documentation of legal status and application of involuntary medication in...

The objective of this study is to provide new knowledge and understanding of the decision making used throughout the seclusion process. Seven mental health nurses and one doctor were each interviewed within 48 hours of making the decision to seclude a patient. The interviews were analysed using content analysis. This study provides valuable information regarding factors that are central to, and...

Dr Zun has done an excellent job of reviewing the many controversies and complexities that surround the use of mechanical and chemical restraint as well as seclusion. He also shows us how many unanswered questions there are about such interventions. For example, an insightful psychiatric resident once raised the question of which intervention was more restrictive and stigmatizing: seclusion or ...

A total of 114 (31%) of 370 acute admissions to an inpatient unit over a one-year interval had at least one episode of seclusion or restraint. Four variables were significant predictors of seclusion and restraint. They were young age, diagnosis of borderline personality disorder, and two scores (irritability and total assets) on the Nurses Observation Scale for Inpatient Evaluation (NOSIE). Mor...