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Improving seclusion practice: implications of a review of staff and patient views


L. Bowers, City Community and Health Sciences, City University, Philpot Street, London E1 2EA, UK, E-mail:


Accessible summary

• An extensive review of empirical literature (n = 39) on patient and staff perceptions of seclusion in psychiatric inpatient settings was undertaken.

• Patients perceived seclusion negatively while staff perceived it to be therapeutic and vital for the running of inpatient units.

• Better communication, more contact with patients and staff engaging with patients before during and after a seclusion episode were suggestions for improvements to care processes.


This review explores patient and staff perceptions and improvement suggestions regarding seclusion in psychiatric inpatient settings. After an extensive literature search, 39 empirical papers were included in the review. According to the literature, patients perceived seclusion to be a distinct negative incident. Staff thought seclusion had a therapeutic effect and believed that units could not operate effectively without seclusion, but regretted that the situation was not resolved differently. Staff and patients had suggestions to improve the seclusion experience. Common themes in relation to the implications for practice are the need for better communication and more contact between patients and staff before, during and after the seclusion event.