Factors Associated with the SECLUSION of Psychiatric Patients

Gerlock, April A.; Solomons, Hope C.

doi:10.1111/j.1744-6163.1983.tb00173.x

Cited by 33 publications

(10 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An earlier study from the USA [12] reported that 1.9 % out of 5580 adult inpatients were exposed to seclusion or restraint. Review articles, based on retrospective studies of mostly small patient samples, showed that seclusion and restraint rates vary widely and that the use of these measures seemed to depend on staff rather than on patient characteristics [13-15]. All these previous studies, however, do not analyse the data regarding different diagnostic groups.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Martin

Bernhardsgrütter²,

Goebel

et al. 2007

Clin Pract Epidemiol Ment Health

View full text Add to dashboard Cite

BackgroundThe use of coercive measures is an indicator of the quality of psychiatric inpatient treatment. To date, there is no data available to European comparisons on the incidence of such measures.MethodsThe frequency and duration of mechanical restraint and seclusion on patients with a diagnosis of F2 ICD-10 was analysed in seven German and seven Swiss psychiatric hospitals in the year 2004 using three indicators. Differences between German and Swiss hospitals regarding the indicators were tested for statistical significance using Mann-Whitney-U-tests.Results6.6 % (Switzerland) and 10.4 % (Germany) of admissions respectively were affected by mechanical restraint and 17.8 % (Switzerland) and 7.8 % (Germany) respectively by seclusion. Seclusion as well as mechanical restraint per case were applied significantly more often in German than in Swiss hospitals and were of significantly longer duration in Swiss than in German hospitals.ConclusionThe results showed different patterns in the use of seclusion and mechanical restraint across Swiss and German hospitals. For future European research on the use of compulsory measures in routine psychiatric care, there is a need for uniformed definitions, reliable documentation of coercive measures as well as for an identical way of data analysis. To meet these conditions is the first step to achieve European standards for the use of coercive measures.

show abstract

Section: Discussionmentioning

confidence: 99%

Untitled

Martin

Bernhardsgrütter²,

Goebel

et al. 2007

Clin Pract Epidemiol Ment Health

View full text Add to dashboard Cite

show abstract

“…Seclusion is considered the last‐resort emergency measure to involuntarily control an individual experiencing serious mental health crisis in psychiatric inpatient hospital settings (Gerlock & Solomons ; Myers ; Putkonen et al . ).…”

Section: Introductionmentioning

confidence: 99%

When reduction strategies are put in place and mental health consumers are still secluded: An analysis of clinical and sociodemographic characteristics

Bullock

McKenna

Kelly

et al. 2014

Int J Mental Health Nurs

View full text Add to dashboard Cite

Internationally, seclusion practices continue to be the subject of intense clinical health service and academic scrutiny. Despite extensive efforts to reduce and eliminate this controversial practice, seclusion remains a clinical intervention widely used in contemporary mental health service settings. Early identification of people who are at risk for seclusion and the timely application of alternative evidence-based interventions are critical for reducing incidents of seclusion in real-world practice settings. This retrospective study aimed to determine the relationship between sociodemographic and clinical characteristics, and the use of seclusion for those mental health consumers for whom evidence-based seclusion-reduction initiatives had little impact. A 12-month centred moving average was fitted to seclusion data from a psychiatric inpatient unit over 2 years to determine stabilization in seclusion reduction. The number of consumers admitted was calculated from the point of stabilization for 1 year (n = 469). In this cohort, univariate analysis sought to compare the characteristics of those who were secluded and those who were not. A multivariate logistic regression model was undertaken to associate future seclusion based on significant independent variables. Of those people admitted, 88 (19%) were secluded. The majority of seclusions occurred in the first 5 days (70/88, 79%). Multivariate logistic regression indicated that three variables maintained their independent associative risk of seclusion: (i) age less than 35 years; (ii) assessment of risk of violence to others; and (iii) a history of seclusion. The implications of these findings for nursing practice are discussed.

show abstract

“…Nearly all previous studies have examined only one containment method, and even of those, only a few have examined patients who are repeatedly subjected to that containment method. For example, only 1 of 118 papers on seclusion contrasted patients who were repeatedly secluded with those who were only secluded once (Gerlock & Solomons, 1983). This paper gives no information on whether and to what extend these same patients were subjected to manual restraint, shows of force, special observation, PATIENTS AND COERCION: STAFF'S UNDERSTANDING 365 or coerced intramuscular medication (IM), as only seclusion is examined.…”

mentioning

confidence: 95%

Patients Subject to High Levels of Coercion: Staff's Understanding

Bowers

Wright

Stewart

2014

Issues in Mental Health Nursing

View full text Add to dashboard Cite

Measures to keep staff and patients safe (containment) frequently involve coercion. A small proportion of patients is subject to a large proportion of containment use. To reduce the use of containment, we need a better understanding of the circumstances in which it is used and the understandings of patients and staff. Two sweeps were made of all the wards, spread over four hospital sites, in one large London mental health organization to identify patients who had been subject to high levels of containment in the previous two weeks. Data were then extracted from their case notes about their past history, current problem behaviours, and how they were understood by the patients involved and the staff. Nurses and consultant psychiatrists were interviewed to supplement the information from the case records. Twenty-six heterogeneous patients were identified, with many ages, genders, diagnoses, and psychiatric specialities represented. The main problem behaviours giving rise to containment use were violence and self-harm. The roots of the problem behaviours were to be found in severe psychiatric symptoms, cognitive difficulties, personality traits, and the implementation of the internal structure of the ward by staff. Staff's range and depth of understandings was limited and did not include functional analysis, defence mechanisms, specific cognitive assessment, and other potential frameworks. There is a need for more in-depth assessment and understanding of patients' problems, which may lead to additional ways to reduce containment use.

show abstract

Factors Associated with the SECLUSION of Psychiatric Patients

Cited by 33 publications

References 14 publications

Untitled

Untitled

When reduction strategies are put in place and mental health consumers are still secluded: An analysis of clinical and sociodemographic characteristics

Patients Subject to High Levels of Coercion: Staff's Understanding

Contact Info

Product

Resources

About