Attitudes to the use of seclusion: has contemporary mental health policy made a difference?

Authors

  • Brenda Happell,

    1. Authors: Brenda Happell, RN, RPN, BA, Dip Ed, B Ed, M Ed, PhD, Director, Institute for Health and Social Science Research and Professor of Contemporary Nursing, School of Nursing and Midwifery, CQUniversity Australia; Stefan Koehn, PhD, Post-doctoral Research Fellow, Institute for Health and Social Science Research and School of Nursing and Midwifery, CQUniversity Australia, Rockhampton, Queensland, Australia
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  • Stefan Koehn

    1. Authors: Brenda Happell, RN, RPN, BA, Dip Ed, B Ed, M Ed, PhD, Director, Institute for Health and Social Science Research and Professor of Contemporary Nursing, School of Nursing and Midwifery, CQUniversity Australia; Stefan Koehn, PhD, Post-doctoral Research Fellow, Institute for Health and Social Science Research and School of Nursing and Midwifery, CQUniversity Australia, Rockhampton, Queensland, Australia
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Professor Brenda Happell, Director, Institute for Health and Social Science Research, and Professor of Contemporary Nursing, School of Nursing and Midwifery, CQUniversity Australia, Bruce Hwy, Rockhampton, Queensland 4702, Australia. Telephone: 07 49306971.
E-mail: b.happell@cqu.edu.au

Abstract

Background.  The use of seclusion in mental health services is controversial, and recent Government policy has identified the reduction and, if possible, elimination of seclusion as a national safety priority. As the professional group most likely to initiate seclusion, the attitudes of nurses will influence the extent to which policy translates to practice.

Design.  The Survey of Nurses’ Attitudes to Seclusion Survey was completed by nurses (n = 123) from eight mental health services from Queensland, Australia.

Methods.  Data were analysed using SPSS to provide descriptive statistics for nurses’ attitudes according to the scale. Correlation analysis was used to examine associations between demographic variables and attitudes towards seclusion.

Results.  Participants recognised the negative impact of seclusion on consumers; however, they continue to support its use, particularly in cases of threatened or actual violence to staff and other consumers. The impact of seclusion room on consumers was viewed as significant and yet most participants did not recommend changes other than painting the room for a calming effect. Demographic factors had limited impact on attitudes.

Conclusions.  The continued support of the use of seclusion despite acknowledgement of its detrimental effects appears to reflect a lack of alternative approaches to the management of consumer behaviours such as violence and aggression.

Relevance to clinical practice.  While nurses continue to view seclusion as a necessary intervention, the success of strategies aimed at reducing its use will be limited. The implementation and evaluation of alternative approaches to the care of consumers is necessary to reduce reliance and seclusion and introduce changes to practice.

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