A survey of the use of seclusion in a psychiatric hospital : a quantitative study

Abstract

The main purpose of this research was to determine whether local policies and practices at a psychiatric hospital in Malta relating to seclusion reflected research based guidelines for its use, and ultimately to employ the results to prompt the redesign of such policies and procedures with a view to reducing the use of seclusion locally. A non-experimental, descriptive methodology was adopted and data was gathered by means of a retrospective survey of all seclusion records, for males and females, for the previous 12 month period. The study sought to ascertain the number of seclusion incidents within the given period and to identify who was involved in the process; the reason for and length of seclusion, and details of the seclusion incident. The results were then analysed and discussed in relation to the existing literature. The results confirmed those of many other international studies. That is: the presence of policies and laws alone are not an effective mechanism for regulating its use; there is a lack of uniformity regarding indicators for placing a patient in seclusion; patient gender may influence its use; culture and individual approaches may have more impact on the decision to seclude patients than patient characteristics; anomalies in the length of seclusion episodes suggest arbitrary use of the intervention that may indicate misuse of the intervention. The findings were assimilated and underpinned the basis of seven recommendations for future service policy design and delivery.