Journal of Korean Academy of Psychiatric

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

1NURSING
Introduction
Hercelinskyj and Alexander (2019) have stated that in recent years, the mental health
service users have made significant efforts in order to reduce the restrictive practices utilized
in the Australian mental health services. The following essay aims to critically discuss the
impact of seclusion towards the consumers and other alike healthcare professionals. The
essay will also discuss the role of registered nursing professionals in collaborating with the
consumers in order to work towards the State/Territory and National initiatives towards
decreasing the overall seclusion and restraint. While discussing the collaborative efforts of
the nursing professionals and the patients, special mention will be given to Safewards
Victoria. The Safewards model and the associated interventions are found to be effective in
reducing the conflict and other containment while increasing the sense of safety and mutual
support for the staffs and the patient (Safewards Victoria, 2020).
Physical restraint in mental health
The application of physical restraint as an intervention in psychiatric nursing dates
back in the beginning of the professional psychiatry care (Colaizzi, 2016). However physical
restrain goes against the basic moral judgements and also against the bio-ethical guidelines of
autonomy. Physical restraint includes devices that are designed for limiting the physical
movements of the patient like limb holders, bandages and safety vests (Cusack et al., 2018).
Physical restraint of complete seclusion is also used to handle violent or maladaptive
behaviour of the mental healthcare service users and thus helping to prevent injury, agitation
and aggression. However, this controlling intervention that is designed to protect patient from
harm is associated with several complications (Wilson et al., 2018). Physical restrain increase
the risk of physical injury and cast negative emotional impact over the life of the mental
health patient. This in turn disrupts the therapeutic alliance between the staff and the patient.

2NURSING
Use of physical restrain over a patient is emotionally exhausting for the healthcare service
providers. Thus use of the coercive interventions is one of the prime indicators for improved
quality of life for psychiatric treatment among hospitalized patient (Moghadam, Khoshknab
& Pazargadi, 2014). Cusack et al. (2018) further stressed that the mental health nursing
professionals are the best person to use their skills and knowledge to address the issues
identified (physical restrain and its effect). This will help in eradicating the risk of restrain
and to better meet the changing needs of the population who are suffering from mental health
complications.
Effect of seclusion and restraint in mental health
Determining the clinical effects of coercion is challenging and it also raises several
questions in the domain of ethical, legal and methodological aspects (Chieze et al., 2019).
Seclusion and restraint have detrimental psychological and physiological consequences.
Application of seclusion and restraint increase the chance of developing post-traumatic stress
disorder. These approaches also lead to the development of negative emotion. The
effectiveness along with the adverse effects of seclusion and restraint seems to be similar. In
comparison to the other coercive measures (mainly the application of forced medication), the
role of seclusion is better accepted. On the other hand, restraint is comparatively less
tolerated. The reason behind this is, perception of seclusion is non-invasive. Proper
therapeutic interaction appears to be significant positive influence over the coercion
perception. Chieze et al. (2019) stated that both seclusion and restrain must be used as the last
line of defence in the mental health nursing as it is associated to significant side-effect like
negative emotional impact over the both the healthcare service users and the service givers.
The extent of the negative emotional impact is higher among the healthcare service user over
which the restrain is administered.