Implementing seclusion in forensic mental health care: A qualitative study of staff decision making [2018]

• There is increasing focus on staff/organisational factors on the use of seclusion.

• Nurses’ decision making to seclude is affected by a number of different considerations.

• Contributory factors are professional and take into account the wider context.

• Nurses being supported with reflection are a key factor in reducing seclusion.

Forensic mental health nursing is a complex role and there is a tension between maintaining safety and promoting a therapeutic and patient centred approach. The use of restrictive practises such as seclusion is an issue. Two focus groups with registered nurses exploring attitudes and factors used in decision-making about seclusion use were analysed using interpretive description. Participants described the need to reduce the use of seclusion and the problematic nature of its utility as an ongoing intervention in contemporary mental healthcare. It was clear that there were complexities and competing variables involved in the decision-making process.

Rachel Green, Catriona Shelly, Jonathan Gibb, Tammi Walker

Archives of Psychiatric Nursing, Volume 32, Issue 5, October 2018