Seclusion rooms were not always used for their intended purpose
Seclusion rooms were not always used for their intended purpose. Asked about
the purpose of seclusion a mental health nurse in another unit said: 'we don’t
view seclusion as a particularly therapeutic tool. It's a management issue'.
Another nurse conceded that: ‘it’s about the circumstances of the person, but also
about what’s happening on the unit at the time’. In one of the units visited, all
three available cells (two 'designated' seclusion cells and one used for overflow)
were occupied by people who were 'transitioning and here to sleep'. In another
unit, only one of five rooms was officially designated as a seclusion room, but all
were identical in appearance and of the four which were occupied at the time of
our visit, all appeared to be used for the purpose of keeping individuals separated
from others: one man was 'transitioning' back to the main unit, another was a
very long term patient who had a bedroom in this unit as well as in the main
unit, a third patient, a woman, had been at the unit for over two months because
of 'inappropriate behaviour', and the fourth patient 'sleeps here because there
is no room for him in the main unit'. This was not good practice. In yet another
unit we were told that placements in the low stimulus area were "usually driven
by perceived dangerousness; actual assault on staff; overstimulation; risk of
escape and overcrowding". Overcrowding is not a justifiable reason for locking
up a patient in a small, barren room with no personal belongings for days on
end, nor is it provided for under the Mental Health (Compulsory Assessment and
Treatment) Act 1992 (section 71(2)).
Stark physical environment
and lack of patient control over
their environment
In all units visited, seclusion
rooms resembled prison
segregation cells, and were
mostly barren other than a
mattress and bedding. In many
of the units visited patients
had little control over their
environment – for example light
switches and blind controls
were located outside the room
and could not be operated by
them. Where some control
was given to service users, for
example, allowing residents of
one health and disability unit
Seclusion room in a health and disability unit
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