Restraint Practices in Mental Health

Running head: SECLUSION AND RESTRAINT PRACTICES 1
Reducing Seclusion and Restraint Practices in Mental Health Services
Name
Institution

SECLUSION AND RESTRAINT PRACTICES 2
Reducing Seclusion and Restraint Practices in Australian Mental Health Services
Introduction
Involuntary consumer incarceration in a room that can disallow a consumer from
physically exiting is referred to as seclusion. the consumer is physically barred from leaving.
Patients that exhibit challenging behaviors such as violence, aggression or self-destruction
(RANZCP, 2016). Restrained refers to any manual manner, physical or mechanical
equipment, material, or device that is used to immobilize or minimize the ability of a
consumer of mental health services to move his or her arms, legs, body, or head freely
(RANZCP, 2016). Chemical restraints comprise using chemicals or chemical processes such
as the use of sedative medication. On some occasions, a drug, which is not part of the normal
medication a consumer’s illness, may be used for restraining a patient, and manage his or her
challenging habit or restricting their liberty to move around. Also, emotional seclusion
involves the use of threats and coercion.
Either seclusion and restraint may be applied in the case where mild coercive strategies
have been deemed ineffective to keep the consumer, or healthcare professional from injury.
The two methods are differentiated from other forms of medical treatment by intention.
Application of seclusion and restraint has raised arguments as they are associated with misuse
and adverse consequences to the patient besides the caregiver. Therefore, in recent years, to
avert the impacts related to seclusion and restraint, there has been a need for registered nurse-
consumer centered approaches to decrease restraining interventions in Australian psychiatric
care (Hercelinskyj & Alexander, 2019)
Impacts of Seclusion and Restraint to Consumers and Healthcare Professionals
Application of restraint and seclusion in Australia is increasing. For instance, in 2018-
19, 11944 mental cases were secluded in national psychiatric facilities and signifies about 7.3
cases of seclusion per a thousand days spent in wards. Relative to 2017-18 data, these rates

SECLUSION AND RESTRAINT PRACTICES 3
were an upsurge from 11,306 incidents of seclusion, equivalent to nearly 6.9 similar
incidents in every thousand days spent in wards (AIHW, 2020).
The two controversial practices can be applied in every part of the interventions within
a psychiatric structure. Nevertheless, seclusion and restraint can be used to offer safe
environment and contain any escalations when they are deemed necessary to protect
consumers, carers, and other persons (AIHW, 2020). It can also be a basis of stress for the
consumer and caregivers, representatives, other consumers, health practitioners, as well as
guests (AIHW, 2020). The application of seclusion besides restraint has been vast in the face
of a severe shortage of research on any positive health outcomes. The use of these practices is
always linked to higher chances of human rights violations, extended injuries, and a risk of
violence (Brophy et al., 2016). For many years, there has been little advancement in
managing psychiatric patients. A part of healthcare practitioners believes that the effective
way of handling these patients is through seclusion and restraint, despite their side effects.
This practice has been seen as brutal and an impediment to the progress of generating new
and better alternatives to mental health care (Raveesh, Gowda &Gowda, 2019). Thus,
registered nurses working with psychiatric patients need to pursue the cause of seeking
alternative management in place of seclusion as well as restraint.
Today, despite knowing that seclusion and restraint approaches are related to various
adverse consequences, mental health services still include them (Sturmey, 2018). Mental
hospitals use these techniques, lack adequate psychiatric structures for practice, and always
may be unable to eliminate them (Knox & Holloman, 2012). These deficits make it
challenging to apply patient-friendly methods of handling aggressive tendencies. Also, such
inadequacy and inappropriate circumstances open doors for employing of seclusion and
restraint. However, mental health caregivers should reflect on the short-term besides the long-
term health outcomes of the consumers they manage.

SECLUSION AND RESTRAINT PRACTICES 4
The immediate consequence of physical restraint is the reduction of violent cases and
unmanageable problem behaviors (Fereidooni, Khoshknab & Pazargadi, 2014). However, the
World Health Organization recognizes seclusion and restraint as non-therapeutic, and there
are several severe harmful effects associated with these practices (WHO,2017). Seclusion and
restraint are linked to physical as well as emotional damage to both patients and caregivers,
with cases of severe bodily harm, and unexpected passing in Australia besides globally (NSW
Ministry of Health, 2017). From the consumer's angle, physical restraint will cause
unanticipated secondary bodily injuries, such as pulmonary illness, skin trauma, deep vein
thrombosis, nerve damage, ischemic abrasions, and even unexpected demise (Ye et al., 2019).
Applying physical restraint also causes mental trauma, for example, low self-esteem, severe
stress, and re-evoking of childhood harm like sexual abuse (Ye et al., 2019). Significantly,
patients exposed to physical restraint have a low quality of life and a sense of hope. Thus,
physical control will exacerbate the stigma on restrained consumers besides impact the
adherence to care.
In another study, restraint is significantly linked to a poor patient-nurse association,
which because of the pertinence of communicating in the management of the
psychologically-impaired individual, has a severe effect on the consumer's caring progression
(Knowles et al., 2015). A restrained patient would blame a nurse and grow doubt towards him
or her. Generally, psychiatric care depends on a partnership between the consumer and nurse,
and the use of restraint or seclusion can affect such an alliance.
Health practitioners are also susceptible to physical injury while using physical
restraint, which is a critical predictor for mental health caregivers applying for sick offs (Ye
et al., 2019). Also, management using physical restraint activates psychological responses
from psychiatric health service providers. Research shows that nurses acknowledge that they
experience difficulty deciding on whether to use physical control or not (Ye et al., 2019).