• Subject Name : Nursing

Use of Seclusion Is Not Essential in An Acute Mental Health Setting

Seclusion is a very common intervention in acute mental health institutes or settings. Seclusion is used in settings for individuals who possess disruptive or aggressive behaviour. Hence, they are put into limited space which involves involuntary isolation of the person (Zheng et al., 2019). However, there are increasing calls to eliminate or reduce the utilization of seclusion. This is because it is considered as harmful for the restrained individual and it breaches their basic human rights. In addition, it disrupts any therapeutic relationship that could be made with the patient. Therefore, keeping all this in mind, the use of seclusion in not essential in an acute mental health setting (Kinner et al., 2017).

Seclusion is done for maintaining the aggressive behaviour of the person so that he doesn’t harm himself. Nurses have the duty to prevent him from any danger. However, there are various ethical concerns regarding seclusion. The foremost being respect for the autonomy of the patient. Autonomy is referred to as the patient's decision for their own health. The dilemma which exists here is between the individual's autonomy and the need to maintain public benefit. It is the responsibility of the health setting to restrain patient from hurting himself but many times this kind of limitation is against the will of the patient. Another ethical concern is the need to preserve justice (Zheng et al., 2019). Patients sometimes are not treated in a fair manner and they lose their right to be valued as an equal person. Some cases have also been reported which stated that patients who were put into a secluded room were not given proper condition and their basic needs and demands were not met (Zheng et al., 2019). Another ethical principle which is compromised while treating patients with mental problems is beneficence. It is the duty of the nurse to prevent and protect the person from hurting. Seclusion was started for the patient's safety but it puts the nurses in the dilemma that how they will maintain the patient’s interests while they are secluded. Therefore, in order to do this, it is important for them to take care of the patient's dignity, integrity and rights (Zheng et al., 2019).

There are multiple legal concerns included in patient’s seclusion as well. The patient sometimes has to deal with inhuman and torture treatment in mental health settings and institution while they are secluded (W Haugom, Ruud &Hynnekleiv, 2019). Seclusion also disrupts their human rights, decision making and empowerment. In addition to all of this, seclusion limits the freedom of the person. Sometimes this benefits the patient but the other times individuals with mental problems feel rage. They also develop the feeling of getting punished and that they are stripped of their rights and humanity. Seclusion can cause trauma to the patients for the rest of their lives (W Haugom, Ruud &Hynnekleiv, 2019).

Therefore, it can be concluded that seclusion might be beneficial for the patient as it will prevent him from self-harm. However, seclusion should not be essential for the patient's suffering from mental health problems as it can cause them many harmful implications such as they lose their right of decision making and acquiring equal care.

References for Ethical Challenges of Seclusion

Kinner, S. A., Harvey, C., Hamilton, B., Brophy, L., Roper, C., McSherry, B., & Young, J. T. (2017). Attitudes towards seclusion and restraint in mental health settings: Findings from a large, community-based survey of consumers, carers and mental health professionals. Epidemiology and Psychiatric Sciences, 26(5), 535-544. https://doi.org/10.1017/S2045796016000585

W Haugom, E., Ruud, T., &Hynnekleiv, T. (2019). Ethical challenges of seclusion in psychiatric inpatient wards: A qualitative study of the experiences of Norwegian mental health professionals. BMC Health Services Research, 19(1), 879.https://doi.org/10.1186/s12913-019-4727-4

Zheng, C., Li, S., Chen, Y., Ye, J., Xiao, A., Xia, Z., Liao, Y., Xu, Y., Zhang, Y., Yu, L., Wang, C., & Lin, J. (2019). Ethical consideration on use of seclusion in mental health services.International Journal of Nursing Sciences, 7(1), 116–120. https://doi.org/10.1016/j.ijnss.2019.10.001

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